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NINTH ANNUAL REPORT 



OF THE 



STATE. 



BOARD OF HEALTH 



OF THE 



STATE OF OHIO, 



FOR THE 



YEAR ENDING OCTOBER 31, 1894, 



COLUMBUS, O.: 

THE WESTBOTE CO., STATE PRi^NTERS. 
1895. 



Ohio State Board of Health, 

Office of the Secretary, 

Columbus, Ohio, January, 1895. 

3o Bis ExcdUncy, Wm. McKinlet, Governor of Ohio: 

Sir : In accordance with Section 8 of an "Act to create and establish a Stat« Board 
of Health," tbe accompanying report is herewith submitted for the year ended October 
31, 1814. 
I_»j.^ Respectfully, 

C. O. Probst, M. D., Secretary. 



MEMBERS OF THE STATE BOARD OF HEALTH. 



Term «xpire«. 
B. Stanton, M. D., President, Cincinnati December, 1866. 



S. P. Wise, M. D., Vice- President, Millersburg 

Wm. T. Miller, M. D., Cleveland 

Thos. C. Hoover, M. D., Columbus 

K. D. Kahle, M. D., Lima 

JosiAH Haetzell, Canton 

E. T. Nelson, M. A., Ph. D., Delaware 



1897. 
189ft. 
18?8. 
1899. 
1900. 
1901. 



C. O, Probst, M. D., Secretary, Columbus. 



Qeneral Report. 



The ninth annual report of the State Board of Health, which is for 
the'year ended October 31, 1894, is herewith presented : 

PERSONNEL OF THE BOARD. 

There has been no change in the membership of the Board since the 
last report, which remains as follows : 

Bryon StsmtonjM.. J)., President Cincinnati. 

S. P Wise, M. D., Vice-President Millersburg. 

E. T. Nelson, A. M., Ph. D Delaware. 

Wm. T. Miller, M. D ^, Cleveland. 

Thos. C. Hoover, M. D Columbus. 

K. D. Kahle, M. D Lima. 

Josiah Hartzell Canton. 

Five meetings were held during the year ; three in Columbus, one 
in Cincinnati, and one in Canton. In January a joint meeting of the 
State and local boards of health was held in Columbus. Over two hun- 
dred and fifty delegates were present and the meeting, which was the 
fourth of its kind, was one of more than usual interest. Quite a number 
of the township boards sent delegates. The time was almost entirely 
given up to discussing practical measures for preventing and restricting 
diphtheria, scarlet fever, typhoid fever and small-pox. The discussion 
and papers were printed in the Sanitary Record and distributed to all 
boards of health, thus reaching those who were unable to attend. 

The results of these meetings are far reaching in their efifects. The 
delegates go back to their respective homes not only better informed, but 
with increased zeal for their work and a higher appreciation of their 
duties as guardians of the public health. These meetings also foster that 
esprit du corps without which public service is but half-heartedly performed. 

Ohio was among the first to establish these meetings of health 
ofl&cials, and the plan has been adopted in many other states. 

HEALTH OF THE STATE. 

The year has been one of general good health. This was especially 
marked as regards the diarrhoeal diseases during the hot months. Within 
the last months of the fiscal year, that is during August, September and 
October, typhoid fever appeared in many parts of the State, and in some 



6 ANNUAL REPORT 

communities assumed almost epidemic proportions. The disease was 
very largely confined to the small villages and rural districts where wells 
furnish the water supply. The unusually prolonged drought had led us 
to expect such results and warning was given, through the press and 
otherwise, and the people who were depending on wells were advised to 
boil all drinking water. Had this been done it is probable that many 
communities would hare escaped the disease. 

SMALL-POX. 

At no period since the Board's creation has the State been more seri- 
ously threatened with small-pox than during the past year. The disease 
was introduced into eleven localities, viz.: Columbus, Springfield, Toledo, 
Cleveland, Shelby, Lima, Worthington, Vinton, Lorain, Collinwood 
and Luckey. In many of these places numerous persons were exposed 
before the disease was discovered, and but for the prompt action of the 
State and local health authorities, small-pox would undoubtedly have 
been widely distributed. 

Small-pox manifested during the year a decided tendency to become 
epidemic, and has not been so prevalent in the United States since the 
epidemic years 1882-3. The disease became firmly established in the city 
of Chicago, and still lingers there. During the year 1894 there were 3,062 
cases of and 1,029 deaths from small-pox in that city. Lines of connect- 
ing railways bring our State into such close relationship with Chicago 
that an unchecked epidemic of small-pox in that city is a serious menace 
to Ohio. There are over nine hundred sweat-shops in Chicago where cloth- 
ing and other textile fabrics are made. Small-pox invaded the sweat-shop 
district during 1893, and as Ohio purchases a large amount of clothing 
from Chicago it was feared that the disease would be introduced through 
this medium. At the instance of the Ohio Board a meeting of State 
health officials was held in Chicago, May 10, with the view of learning 
the exact situation as regarded small-pox, and the danger of its impor- 
tation to other states. 

The investigation showed that our fears were well founded ; and that 
clothing was being sent out of the sweat-shops of Chicago and presumably 
into our State which was liable to convey small-pox. On a subsequent 
page may be found a report of a conference between the health officials 
of the various states represented, including the state of Illinois and the 
city of Chicago, and the wholesale clothiers of Chicago. It was agreed 
that certain additional precautions with respect to clothing should be 
taken, under the general supervision of the Illinois board of health. The 
clothiers offered to pay all necessary expenses. 



OHIO STATE BOARD OF HEALTH. 



VACCINATION. 



The prevalence of small-pox in the United States and its introduc- 
tion into our own State led the Board at its October meeting (1893) to adopt 
a rule requiring all children attending the public schools to show evidence 
of successful vaccination. Local boards of health and boards of education 
were called upon to enforce this order. 

As was to have been expected, the order met with considerable oppo- 
sition. It is improbable that many of our people are opposed to vaccina- 
tion per se, but the anti- vaccinationists unite with them many who are 
opposed to compulsory measures of any kind, and together they succeeded 
in many communities in prsventing the enforcement of the order. On 
account of interference with school attendance many of the school authori- 
ties were opposed to vaccination, or at least until vacation. The 
country at the time was in the midst of a financial panic, and thousands 
of workmen were out of employment, and the expenses of vaccination at 
such a time operated against enforcing the order. 

For these and other reasons it was considered wise to suspend the 
general order for vaccination, leaving it optional with the local author- 
ities to enforce vaccination of school children. It is not necessary here 
to enter into an argument for vaccination. The world's experience pro- 
nounces unqualifiedly in its favor, and without its use small-pox would 
doubtless again become one of the scourges of mankind in spite of im- 
proved sanitary conditions. 

At present, in Ohio, the board of health or board of education of 
any municipality may require children attending public schools to be 
vaccinated, and such a rule is enforced in many of our cities. 

Far greater protection would be given the State if this rule were en- 
forced as regards all pupils, and we respectfully recommend that a law 
requiring vaccination of school children, and applicable throughout the 
State, be enacted, and boards of health charged with its enforcement, 

CONSUMPTION. 

Consumption is now classed among the preventable diseases, and the 
present year has been selected as a favorable time to turn attention to 
measures^for its prevention. 

The fact that consumption and other forms of tuberculosis may be 
communicated from one person to another is not new. During the I8th 
century the Kingdom of Naples, which then embraced a considerable 
portion of Italy, enforced the most stringent laws against consumption 
as a contagious disease, and the efiect was seen for many years after the 
operation of these laws ceased, in the comparative immunity to consump 



S ANNUAL REPORT 

Mon which Naples enjoyed. Subsequently, from the teachings of medical 
men that consumption is an inherited disease, the people gave up the 
idea of its contagiousness, and no precautions were taken to prevent its 
spread. When Prof. Koch in 1882 announced that he had discovered a 
micro-organism which is the cause of tuberculosis the way was again 
opened up for the |enforcement of preventive measures. But before 
restrictions can be placed upon persons suffering from consumption, and the 
patients or their friends be induced to destroy the tuberculous sputum in 
which the germ of the disease is found, it will be necessary to re-educate 
the people to the doctrine of the contagiousness of the disease ; and this 
is the work that has been taken up by the Board. First a preliminary 
circular was sent to each physician in the State, asking his aid and sup- 
port in the proposed movement against consumption. The result was 
f ery gratifying, the replies indicating that there is practically unanimity 
among the profession in considering consumption a preventable disease, 
and in a willingness to assist the Board in any way possible. Valuable 
information was also received in regard to the transmission of the disease 
from husband to wife and vice versa. This is reported upon in full on 
following pages. 

A pamphlet was then prepared on "The Prevention of Consumption" 
and 100,000 copies printed. A second circular was sent to each physician 
with copies of the pamphlet with the request that a copy be left in each 
family to which he was called on account of consumption. The pamphlet 
was printed entire in a large number of English and German papers, so 
that the information it contains has been widely circulated. 

Not less than five thousand annually fall victims to this disease in 
Ohio, selected for the most part from those in the prime of life. Now 
that the way has been pointed out by which this needless waste of life 
may be stopped or greatly lessened, it must rest with the people to 
demand that such restrictions shall be placed around those unfortunate 
enough to contract the disease as will prevent its dissemination. 

It is a well established fact that the meat, and especially the milk 
of cows suffering from tuberculosis may contain the organism which 
produces the disease, and it is highly probable that the great prevalence 
of tubercular affections of the bowels in infants is largely due to the use 
of such milk. The State should deal with this matter by providing for 
4he inspection of dairy herds. It is possible with great certainty to detect 
tuberculosis in the living animal by the injection of tuberculin, and an 
inspection with the use of this agent in suspected cases of tuberculosis 
iBhould be made of all dairy animals in the State. 



OHIO STATE BOARD OF HEALTH. 



WATER SUPPLIES AND SEWERAGE. 



By an act of 1893 the State Board of Health was charged with the 
duty of approving all public water supplies, and all systems of sewerage, 
with respect to their outlets, introduced subsequent to that time. 

This act has met with general public approval, as it insures that 
public works of this character, which have such close relationship to the 
public health, shall be under State supervision. 

When a city or village proposes to introduce water works or sewerage, 
or change the source of supply or sewerage outlet of works already in 
use, application is made to the State Board of Health. A committee of 
the Board visits the place, looks carefully into all matters likely to affect 
the health of the people of that or neighboring communities, collects 
samples of water for examination, when water works are proposed, and 
the plans are approved or disapproved according to the evidence so ob- 
tained. 

During the year the Board has been called upon to approve plans for 
public water supplies in the following places, to-wit : Bowling Green, 
Lancaster, Lima, Louisville, Gallipolis, Napoleon, Nelson ville and 
Wooster. These were all approved. Plans for sewerage were submitted 
for approval by the following places, to-wit: Athens, Ashtabula, Ham- 
ilton, Marietta, Nelson ville and Warren. The plans were disapproved 
for Marietta and Warren. These were subsequently amended in con- 
formity with the requirements of the Board. 

MONTHLY SANITARY RECORD. 

On account of the reduction in the annual appropriation for the 
Board it was found necessary to stop the publication of the Monthly 
Sanitary Record. This is to be regretted. The journal was started in 
January, 1888, and was issued each month to April, 1894. 

Its main object was to strengthen the connection between the State 
and local boards of health and keep alive their interest in sanitary work.- 
In this it has been very successful ; and the perfect organization and 
efficiency of the health service are in no small part due to this publication. 
The journal reached many besides health officials and was an important 
factor in disseminating information calculated to improve the public 
health. 

« LOCAL BOARDS OF HEALTH. 

Our local boards of health have made considerable gain both in 
numbers and efficiency. There are now 552 municipal and 1,066 town- 
ship boards of health in the State. This gives a working force of not less 
than ten thousand men more or less actively engaged in sanitary work. 



lO ANNUAL REPORT 

There remain 136 villages and 287 townships which have failed to 
establish boards of health. Every effort is being made to complete the 
organization of local boards, and we trust soon to be able to report that 
every city, village and township is provided with an organization specially 
charged with the protection of the public health. 

LIBRARY. 

This report contains a complete catalogue of the library of the Board. 
It shows the collection of a considerable number of valuable works and 
reports on sanitary matters. 

In this connection it is desirable to call attention to the inadequacy 
of the quarters assigned to the Board. A room 25x15, opening on an 
inner court, so dark that artificial light must be used every day in the 
year, is " The office of the State Board of Health. " One side of this room 
is entirely occupied by the library case, which is completely filled. Un- 
less some other provision is made, future additions to the library must be 
consigned to the basement and destruction. 

A detailed report of the work of the Board, including reports of special 
investigations made during the year, follows. 



Secretary's peport. 



Absteact of Proceedings at Meetings of the Board Held During 

THE Year. 



DECEMBER MEETING. 

A special meeting of the State Board of Health was held in Columbus 
December 7, 1893. Present: Drs. Wise, Stanton, Kahle, Hoover, Mr. 
Hartzell and Professor Nelson. Attorney General Richards and School 
Commissioner Corson were also present. 

The President called the meeting to order at 7:45 p. m., announcing 
that the meeting had been called to consider the question of postponing 
the date of required vaccination of school children. 

The Secretary presented a report on vaccination, showing the legal 
and various other obstacles with which local authorities were meeting in 
attempting to enforce vaccination of school children. 

On motion of Dr. Hoover the report of the Secretary was received. 
The Attorney General advised that local boards of health be requested to 
adopt as their own a vaccination order similar to the order of the State 
Board of Health. 

Dr. Stanton moved that the tijcne for enforcing the vaccination order 
be extended to September 1, 1894. Seconded by Dr. Wise. The Attor- 
ney General oflered as an amendment, that the order should be enforced 
immediately after the holidays, and that the Secretary be instructed to 
issue a circular requesting local boards of health to adopt the order. 

Dr. Kahle offered an amendment to the amendment, fixing the time 
at January 8, 1894. The Attorney General accepted the amendment. 

The question on the amendment was put and carried. 

The question was then put on the original motion, as amended, and 
was carried. 

The State Commissioner of Schools offered to issue a circular letter 
to boards of education requesting them to co-operate with the boards of 
health in enforcing vaccination. 

On motion of Dr. Hoover the offer was accepted, and a vote of thanks 
tendered the Commissioner for the proffered service. 



12 ANNUAL REPORT 

The Secretary presented a letter from Mr. Rank, of Canton, superin- 
tendent of the Canton Cemetery Association, requesting permission to 
remove the dead bodies of two children from Canton to Pittsburg, the 
cause of death of one child having been membranous croup. 

On motion of Dr. Stanton it was voted to refuse the request as regards 
the child who died of membranous croup. 

On motion of Professor Nelson the Secretary was instructed to send 
congratulations to Dr. Murray, of the Marine Hospital Service, on his 
successful fight against yellow fever at Brunswick, Ga. 

No further business presenting, the Board adjourned. 



JANUARY MEETING. 

A regular meeting of the State Board of Health was held at the office 
of the Board in Columbus, Ohio, 7:30 p. m., January 24, 1894. 

Present : Professor Nelson, President, in the chair, Drs. Kahle, Hoover 
and Stanton. Mr. Hartzell reported later. 

The minutes of the October meeting and of the special meeting held 
December 7, 1893, were read and approved. 

The Secretary presented his quarterly report. On motion of Dr. 
Hoover the report was received. 

QUARTERLY REPORT OF THE SECRETARY. 

Mr. President : I beg leave to present the following report : 

Since the last meeting of the Board I have been called from the 
office twice. 

On December 12, I was called by telegram to Austinburg, Ashta- 
bula county, on account of diphtheria. I have made a special report of 
my visit, which will be presented later. 

January 9, I went to Circleville at the request of the board of health. 
A special meeting of the board was called in the afternoon, at which all 
the members were present. I was informed that the board had just been 
organized, and had requested me to come in order that they might be 
better informed as to their powers and duties. Heretofore, it was stated, 
but little eflfective work had been done, and scarlet fever had been per- 
mitted to linger in the city for the past two or three years. The members 
of the present board expressed the determination to enforce needful 
regulations if this could possibly be done. The board specially desired 
to appoint a health officer who would give his whole time to the work. 
It was feared that council would object to paying an adequate salary. I 



OHIO STATE BOARD OF HEALTH. 1 3 

advised the board to first unofficially approach members of council and 
learn if they would concur in the appointment of a health officer at six 
hundred dollars (S600 00) per year. If objections were found, to appoint 
the health officer, fix his salary, and if payment were refused, to carry the 
matter into the courts. 

I trust that we may be able, at no distant date, to secure legislation 
providing for an annual levy ior sanitary purposes, placed directly to the 
credit of the boards of health. 

I was able to give the board of health some assistance in arranging 
for reports and preventive treatment of infectious diseases, for the collec- 
tion of births and deaths, and other matters connected with the work of 
a board of health. 

Several outbreaks of small-pox have been reported during the quarter. 

One case was reported near West Williamsfield, Ashtabula county. 
The attending physician reported that this case developed one week after 
vaccination ; that there had been no other exposure, and that he attrib- 
uted the disease to vaccination. The case was reported to the township 
health authorities as small-pox, and quarantine was established and 
maintained until the patient recovered. 

In writing to the township authorities in regard to the case I assured 
them that vaccination never gave rise to small-pox, but that as it was 
possible the patient had in Jact been exposed to small-pox prior to vac- 
cination, they should maintain quarantine eo long as the case was con- 
sidered small-pox. 

A somewhat similar case, but of more interest on account of the child 
having been accidentally vaccinated, occurred at Harrod, near Lima. 
Dr. Kahle was requested to investigate the case and will be able to make 
a full report of it. 

The papers reported two cases in Delaware county. By telegraphing 
to the township health authorities and to the attending physician I was 
able to learn that the disease was measles. The report was promptly 
contradicted. 

Three cases have been reported in Columbus. 

Since the special meeting of the Board, December 7, small-pox has 
been reported in other states, as follows : 

December 11, thirty-six cases at Reading, Pa., making six hundred 
and seventy-eight cases to date given, with eighteen deaths. Eleven cases 
reported in other parts of the same state. 

December 23, fifty- six cases in Chicago, making one hundred and 
««ven cases to date given. 

December 29, two cases in Durham county, Ontario. 

January 4, one oa«e in N«w Haven, and five in Winehester, Conn. 



14 ANNUAL REPORT 

January 8, five cases in Hamilton, Ontario, 

January 9, nineteen cases in Massachusetts, making thirty-four since 
December 1. 

January 11, seven new cases in Reading, Pa., making seven hundred 
and ten cases to date given, with eighteen deaths. New cases reported in 
ten other places in the state. 

January 22, three cases reported at Lewisburg, W. Va. 

Feeling some uneasiness in regard to small-pox in Chicago, and hav- 
ing no late reports from there, I requested Dr. Scott, secretary of the 
Elinois board, to inform me of the exact situation there. The following 
reply was received : 

Sfringfield, Ii.i, , January 17, 1894. 
C. O. Pkobst, M. D., Secretary Slate Board of Health, Columbvs, Ohio : 

Dear Doctor : Yours making inquiry regarding the small-pox status in Chicago 
to date, at hand. I am sorry to say that I am not able to give you reliable information 
as to the extent of the disease in Chicago since my last report. 

I called Monday, while in Chicago, upon the Commissioner of Health, and was in- 
formed by him that the disease had developed more rapidly in the city during the 
pres-nt month than at any other time. He stated that, owing to the over-worked con- 
dition of his force in looking after those aSected with small pox, he had been unable to 
furnish a report, but would do so in a few days. 

Enough is known to warrant me in asserting that the disease is increasing rapidly 
in the city, new centers of infection being frequently discovered. The action of the 
local authorities has been prompt and efficient and everything has been done and Is 
being done to arrest the progress of the disease. 

Vtry truly yours, 

(Signed) J. W. Scott, Secretary. 

Recent press dispatches from Chicago report that the authorities have 
determined to drive out the tramps, unwilling to work, of whom it was 
estimated there were fifteen hundred. There would appear to be consid- 
erable danger of spreading the disease in this manner. 

Through the courtesy of the U. 8. Consul at Bradford, England, Mr. 
Claude Meeker, former Private Secretary of Governor Campbell, I have 
been able to obtain, in advance of printing, a copy of his report on small- 
pox in that city. It contains some interesting facts which I will present 
to the Board if desired. 

The correspondence has been unusually heavy during the past quar- 
ter ; 1,656 written communications were received and 1,581 letters written. 
In addition 11,500 circular letters were sent out. 

There are 685 cities and incorporated villages in Ohio and 549 munic- 
ipal boards of health, leaving 139 villages unorganixed. 

A written letter has just been sent to the mayor and council of each 
of these, urging that a board of health be established at once. 



OHIO STATE BOARD OF HEALTH. 1 5 

Of the 1,353 township boards provided for by the act of Maroh 14, 
1894, 969 have reported as organized. A circular letter to the trustees of 
these unorganized townships will be sent out soon. 

Preparations have been completed for the joint .'meeting of the State 
and local boards to be held to-morrow, January 25. Special rates to dele- 
gates have been secured on all railroads. The Governor has been invited 
to be present, and has promised to make a few remarks if possible to 
come. I have also invited members of Legislature who are physicians. 

Respectfully submitted. 

C. 0. Probst, Secretary. 

The committee on straw board works presented a letter from the 
secretary of the Fish and Game Commission, offering aid in preventing pol- 
lution of streams by the waste of such industries. On motion of Dr. 
Stanton the report was received, and the committee continued. 

The Secretary reported the results of examination of the water supply 
of the Epileptic Hospital. On motion of Dr. Hoover the Secretary was 
instructed to secure other samples of the water for bacteriological and 
chemical examination. 

A communication was presented from George F. Hammond, archi- 
tect, of Cleveland, relative to additions to the hospital at the 0. S. & S. O 
Home. The communication was ordered filed. 

A communication was presented from Dr. A, W. Smith, of Cleveland, 
relative to examination of river waters. On motion of Dr. Stanton the 
Secretary was instructed to thank Dr. Smith for his offer, and to state 
that work in that direction would depend upon the amount of appropria- 
tion received. 

A communication was read from Dr. R. D. Murray, of the Marine 
Hospital Service, stationed at Brunswick, Ga., in answer to a congratu- 
latory letter from the Board. The communication was ordered filed for 
publication. 

The Secretary presented facts concerning the violation of the rules of 
the Board by the Adams Express Company in shipping dead bodies to 
Zanesville, Ohio, cause of death having been diphtheria. The Secretary 
was instructed to call the attentiqn of the proper officials to the violation. 

The Secretary presented correspondence relative to the drainage of 
the court house and jail at McArthur. On motion of Dr. Stanton the 
Secretary was appointed to investigate the complaint, and report. 

Complaints as to the pollution of Plumb creek by the sewerage of 
Oberlin were read by the Secretary. The Secretary was instructed to go 
to Oberlin and invegtigate the complaints. 

No further business presenting, the Board adjourned, to meet the 
following day with the representatives of local boards of health. 



I 6 ANNUAL REPORT 



APRIL MEETING. 



A regular meeting of the State Board of Health was held at the 
Burnet House in Cincinnati, April 24 and 25, 1894. 

All members were present. Professor Nelson in the chair. 

The minutes of the last meeting were read and approved. 

The Secretary presented his quarter!}' report, which was approved. 

QUARTERLY REPORT OF THE SECRETARY. 

Mr. President : Your Secretary begs leave to submit the following 
report lor the quarter ending April 24, 1894 : 

Following the January meeting the proceedings of the conference of 
State and local boards of health were edited and printed in the Sanitary 
Record. Owing to delay of the stenographer in furnishing a transcript 
the journal was not issued until the last of February. The cost of print- 
ing five thousand copies was $420.00. 

According to instructions I visited Mc Arthur on February 22, 
and investigated the complaint made with reference to the sewerage of 
the jail and court house. I found there was little or no cause for com- 
plaint. A 20-inch sewer had been laid, into which the court house, 
jail and one hotel drain. The sewer runs with good fall to a small stream 
which flows constantly, and enters it fully one-lourth of a mile distant 
from any house. No nuisance had been created, nor is it likely that one 
will be. A special meeting of the local board of health was called, at 
which all members were present, and the entire afternoon was spent in 
discussing various sanitary problems in which the board is interested. 

A communication was sent to the manager of the Adams Express 
Company in regard to the shipment, to Zanesville, of the bodies of per- 
sons who had died of diphtheria. He made an investigation and submit- 
ted the correspondence to rne, but with the request that I return it, which 
was done. The charges were admitted to be true, but the plea was made 
that the bodies had been received in states where they were allowed trans- 
portation when shipped in an hermetically sealed case or casket. The 
Ohio rules, they stated, had not been knowingly violated, and they prom- 
ised strict compliance in the iuture. Pursuing this matter, I wrote 
a letter to the general manager of each railroad operated in Ohio, 
calling special attention to the amendment of the rules of the Board, 
which prohibits shipment of bodies of those who have died of diphtheria, 
and requesting copies of their published rules governing transportation of 
dead bodies. Their attention was also called to the fact that.the National 
Association of General Baggage Agents had recently amended its rules in 
conformity to this change in the rules of the Ohio Board. *. 



OHIO STATE BOARD OF HEALTH. 1 7 

I found that a considerable number of the roads were still working 
under the old rules, allowing shipment of bodies dead of diphtheria. A 
number of these promptly amended their rules, and furnished copies of 
the same. The following railroads have adopted rules similar to those of 
this Board, as adopted June 30, 1894 : 

Norfolk and Western; Baltimore and Ohio; Ohio Central; Cleveland, 
Cincinnati, Chicago and St. Louis; Michigan Central; Cincinnati and 
Muskingum Valley ; Pittsburg, Cincinnati, Chicago and St. Louis ; Cin- 
cinnati, Hamilton and Dayton ; Wabash ; Columbus, Hocking Valley and 
Toledo ; Queen and Crescent ; Lake Shore and Michigan Southern ; 
Zanesville and Ohio River ; Toledo, Ann Arbor and Northern Michigan ; 
Lake Erie and Western ; Toledo, St. Louis and Kansas (^ity ; Valley 
Railway ; Cincinnati, Jackson and Mackinaw ; Cincinnati, Georgetown 
and Portsmouth ; and New York, Chicago and St. Louis. 

The Ohio Southern has rules prohibiting transportation of bodies 
dead of contagious diseases. The Cleveland and Canton, the Cleveland, 
Canton and Southern, and the Pittsburg, Lake Erie and Western use the 
former rules allowing the transportation of a diphtheria corpse. 

The following railroads transport corpses on physicians' certificate 
that death was not caused by a contagious disease : Cincinnati, Ports- 
mouth and Virginia ; Dayton, Lebanon and Cincinnati ; Findlay, Fort 
Wayne and Western, and the Cleveland and Marietta. 

In accordance with instructions, fresh samples of water were secured 
from the Epileptic Hospital. The following reports of examinations, have * 
been received. In explanation of the difierent results obtained, as com- 
pared with former examinations, I learned that the first samples had been 
collected Avithout care ; the one for chemical examination from the 
kitchen hydrant without washing out the pipe, and that for biological 
examination from a leak in the pump. 

Columbus, Ohio, February 8, 1894. 
Db. C. O. Pkobst, Secretary Ohio State Board of Health : 

DfiAB Sir : I have completed a chemical analysis of the second sample of water 
received from the Hospital for Epileptics at Gallipolis, with the following results : 

Parts per 100,000. 

Oxygen Free Albuminoid Nitrous Chlorine. Total 

required. ammonia. ammonia. acid. solids^ 

.07 .0005 .005 .001 .52 36.2.' 

The physical appearances of this water were very diflferent from those of the fim*, 
sample received in December. This sample was very clear and not slightly turbid &^ 
was the first sample. The chemical analysis shows a very different water. This sample 
is of a high degree of organic purity, as is shown by the extremely small quantity of the 
constituents above named. 

Yours truly, 

(Signed) Cobtis C. Howard. 

2 ST. B. H. 



lo ANNUAL REPORT 

Db. C. O. Probst, Secretary Stale Board of Health : 

Dear Sir : The second sample of water from Gallipolis asylnm, received on the 
10th instant, was perfectly clear and colorless, thus differing materially from the first 
sample. 

Four plate cultures were made, and they showed that the water contained ten (10) 
bacteria to the cubic centimetre. 

This water accordingly is to be pronounced exceptionally pure. 

Respectfully, 
(Signed) A. M. Bleii.e. 

Since the last meeting of the Board in January, small-pox has 
appeared in seven different places in the State. By prompt action there 
has been little spread at any place. A history of these outbreaks will be 
given in a special report. 

I went to Chicago in February to confer with the secretaries of the 
Illinois and Indiana State Boards of Health on the small- pox situation 
in Chicago. A meeting was held at which were present, Dr. Reynolds, 
Health Commissioner of Chicago, Dr. Ware, ex-commissioner. Dr. John 
B. Hamilton, of the Marine Hospital Service, and representatives of the 
Illinois, Indiana and Ohio State Boards of Health. 

Dr. Reynolds made a report as to the extent of the epidemic and 
measures being enforced to control it. From his statements it appeared 
thatjproper precautions were not being taken. Domiciliary quarantine 
was enforced in many cases only by placarding, and a considerable num- 
ber of cases were being treated in this manner. No provision was made 
for the isolation of suspects, and persons exposed to small-pox were 
not quarantined ; thej^ were simply vaccinated, and allowed to go. 

The situation was freely discussed, and Dr. Reyjjolds agreed to adopt 
the principal measures suggested by the conference. I subsequently 
learned that a house to house inspection was made through the police 
force — against their wishes — but no cases were found, as the houses were 
not searched. 

A circular letter was mailed on February 5, to all general managers 
and superintendents of railroads operated in Ohio, calling attention to 
the prevalence of small-pox in the United States, and urging that railway 
employes be vaccinated. As a result, most of the railroad employes in 
Ohio were vaccinated. 

On February 28, a circular letter was sent to all local health author- 
ities in Ohio, urging them to co-operate with the police authorities in 
securing the examination and vaccination of tramps applying for permis- 
sion to sleep in station houses. 

I do not know to what extent the suggestions were carried out. Sub- 
sequently the Indiana and Illinois boards took similar action as regards 



OHIO STATE BOARD OF HEALTH. 1 9 

vaccination of railway employes, and the Indiana board adopted a 
mandatory order requiring local authorities to vaccinate tramps. 

A considerable number of the recent outbreaks of small-pox in the 
United States has been traceable to tramps, and if this order could be en- 
forced in all the states this danger would be largely removed. At no time 
since the epidemic of 1881-2-3 have there been so many centers of small- 
pox infection in the United States. The disease continues unabated in 
Chicago. For the week ending April 15, one hundred and twenty-six 
new cases were reported there. The pest house contains one hundred and 
eighty-six cases, and is overflowing. The Cook county hospital recently 
admitted ten cases which proved to be small-pox; and over lour hundred 
persons are quarantined there. 

April 11 and 12, I attended a meeting of the State and Local Boards 
of Health of Indiana, held in Indianapolis, and had the honor to make 
an address on "Some of the Difficulties that Beset a State Board of 
Health"'. Dr. J. W. Scott, secretary of the Illinois board, presented an 
excellent paper on "General Sanitation." 

The meeting was well attended — about one hundred and fifty being 
present— and the papers and discussions were of more than usual interest. 
Of special interest was a report on the Muncie small-pox epidemic by Dr. 
Cowen, of Muncie. He made a special plea for hospital quarantine, which 
was carried out in nearly all the Muncie cases. A number of patients 
were forcibly removed, and in one instance a board of health employe was 
shot while doing so. The precedent was established that, in Indiana at 
least, boards of health may take small-pox patients to a hospital by force 
of arms if required. These patients were removed from the city on the 
ground that they constituted a public nuisance. 

Some very interesting vaccination statistics were presented, which 
give a much better showing for vaccination in the Muncie epidemic than 
was at first reported. 

A very interesting report was made by the secretary of the Indian- 
apolis Sanitary Society, which is composed of ladies. The report showed 
that they are doing a very useful work in sanitary education, and that 
such a society can very materially strengthen the hands of the local health 
department. I would suggest that this Board should encourage the forma- 
tion of similar societies in large cities of Ohio. 

Governor Mathews, of Indiana, made a pleasing address, and placed 
himself on record as a friend of State Boards of Health. A closer alliance 
was made with Indiana and Illinois with whose sanitary interests Ohio is 
closely identified. 



20 ANNUAL REPORT 

I remained a day to investigate a press report that a tramp 'jjfrom 
Chicago, sufifering from small-pox, had been driven out of Indianapolis, 
and had gone to Cincinnati. The report was true, except that the patient 
had fully recovered, having been dismissed from the Chicago pest house 
two weeks before coming to Indianapolis. 

I have a special report to offer of our inquiry made as regards con- 
sumption. 

Respectfully submitted. 

C. 0. Probst, Secretary. 

Reports were presented by the committee on sewerage and drainage 
with reference to — 

(a) The application of the mayor and council of the city of Warren 
to discharge sewage into the Mahoning river ; and 

(6) The application of the sewer commissioners of Marietta to dis- 
charge sewage into the^Muskingum river. 

On motion of Dr. Stanton the reports were approved. 

Dr. Stanton presented a report of an investigation of scarlet fever at 
Loveland. 

On motion of Dr. Hoover the report was accepted and its sentiments 
endorsed. 

The Secretary offered the following resolution : 

Whekeas, It is highly desirable in the interest of the public health, that health 
officers shall be properly qualified for the responsible duties of their position; and 
Whereas, Physicians are usually selected for health officers ; therefore, be it 
Besolved, By the Ohio State Board of Health, that medical examining and licensing 
boards of the various States be respectfully urged to provide, where permissible, that 
medical colleges, to be considered in good standing, shall devote not less than forty 
hours to the teaching of hygiene and require an examination in that branch of medical 
education. 

On motion of Dr. Hoover the resolution was adopted. 

Dr. Hoover spoke of the danger of possible outbreaks of small-pox 
occurring in so-called commonweal armies passing through the State, and 
moved that a committee be appointed to present the matter to the Gover- 
nor, and urge that vaccination of such armies be required before permit- 
ting them to come into the State. 

The motion was carried, and Dr. Hoover and the Secretary were 
appointed a committee to wait upon the Governor. 

On motion of Professor Nelson the committee was authorized to look 
after the vaccinal protection of armies already within the State. 

The Secretary presented the following circular addressed to railway 
authorities in regard to railway sanitation : 



OHIO STATE BOARD OF HEALTH. 21 

Ohio State Board of Health, 
Secretaey's Office, Columbus, O., May 1, 1894. 
To General Managers and Superintendents of Railroads : 

Dear Sirs: With the approach of warm weather the danger of the appearance of 
such diseases as are known to have their origin in filth is greatly increased. Eecent 
news from abroad indicates also that this country will again be threatened with cholera 
during the present year. It is known that the unsanitary condition of many railway 
stations is quite a factor in the production of these disorders. 

It is therefore ordered by this Board that you cause to be inspected all depots, build- 
ings, out-houses, feed yards, cattle pens, chutes, etc., with a view of ascertaining and 
correcting such unsanitary conditions as may be found to exist. 

It is requested that suchjinspection be made, and a report thereof be furnished this 
Board not later than June 1, 1894, as after that time we intend to have the results 
reviewed by our own inspectors. 

In line with the above, we beg to offer the following suggestions : 

Stations should be looked after as regards cleanliness, disposal of excreta and 
water supply. 

Waiting-rooms and their surrounding yards should be thoroughly cleaned. Horse 
manure, and animal and vegetable refuse of all kinds should be removed. Low places 
about stations collecting stagnant water should be filled or drained. 

Care should be taken to obtain water for stations from a pure source. Suspicion 
should attach to water from a well within 100 feet of an uncemented privy vault. Drink- 
ing vessels should be washed at least once daily. 

Full or foul privy vaults should have their contents removed and the vault disin- 
fected. A privy vault should never be permitted to be filled up and abandoned without 
first having its contents removed. 

Where water closets are in use, care should be taken to insure that all fixtures are 
properly trapped, and that the traps are in working order. Closets should be made clean, 
and it would be well to treat them with liberal amounts of a disinfectant solution. 

In the sanitation of trains we would emphasize the importance of giving attention 
to the following points : 

Great care should be taken to insure purity of water furnished passengers for drink- 
ing; and not only should its source be closely scrutinized, but the after care of it should 
be kept in mind. In this connection we desire to call your attention to the disgusting 
and also dangerous method in vogue for supplying water tanks with ice. Where these 
tanks are charged from the top, the ice, after it is broken to suitable size, is handled at 
least twice by men with dirty begrimed and possibly infected hands ; where the ice is 
brought into the cars, by the dirty hands of at least one workman. This practice should 
be broken up, not only for the sake of cleanliness, but because there is real danger of 
infecting the water supply of trains. 

Water tanks should be thoroughly cleaned at frequent intervals, and it would be 
advisable when doing so to have them scalded inside. 

Passenger cars should be kept in the cleanest possible condition. The frequent 
practice of sweeping and dusting cars enroute when occupied is most reprehensible ; it is 
most disagreeable to passengers, and should be stopped, as the dust so raised may often- 
times be infected. Instead, they should be cleaned by damp mops and cloths. 



2 2 ANNUAL REPORT 

Each car should be provided with a reliable thermometer, and conductors should be 
instructed to keep their cars heated in winter or cool weather, not above 70° nor below 
60° F. Conductors should also be required to pay special attention to the ventilation 
of their cars. Urinals and water closets should be thoroughly cleaned, and flushed with 
a disinfectant solution at the end of each trip. The floors of water closets should be 
mopped with a disinfectant solution. 

By carrying out these and other measures of cleanliness that may suggest them- 
selves, railroad companies can do much towards securing the health and comfort of the 
traveling public; and from the interest you have heretofore exhibited in sanitary reforms, 
we confidently expect your cordial co-operation in this effort to protect the public health. 

As the public is rightfully interested in knowing what is done by your company 
along the lines suggested herein, we beg you to favor us with a detailed report of the 
work done by June 1, in order that we may embody it in a report we will make on this 
subject. 

Additional copies of this circular may be obtained if desired. 
Respectfully, 

C. O. Probst, M. D., Secretary. 

On motion of Dr. Wise the Secretary was instructed to have the 
circular printed and sent to all railway authorities operated in Ohio. 

The Secretary reported that the United States Postal authorities had 
ruled out the " Monthly Sanitary Record " as second class matter, and 
that this would increase the postage on the journal $600.00 or more per 
annum. 

On motion of Professor Nelson it was voted that no action be taken 
on the matter until the next meeting, and that an attempt be made to 
have the journal reinstated. 

Dr. Hoover introduced the following resolution and moved its 
adoption : 

Resolved, That the State Board of Health, through the investigation of the cases of 
scarlatina occurring in Loveland, Ohio, on the 13th day of April, are of the opinion 
that the local board of health of said village did grossly neglect the requirements of this 
Board in the management of contagious diseases and that the great fatality in said out- 
break was doubtless due to said gross neglect ; and 

Resolved, That the action of said local health board is strongly condemned. 

Dr. Stanton moved to amend by striking out the clause " and that 
the great fatality in said outbreak was doubtless due to said gross neglect." 
The amendment was adopted. 

On motion of Dr. Stanton the resolution, as amended, was adopted. 
Adjourned to 9 a. m., 25th of April. 



OHIO STATE BOARD OF HEALTH. 23 

SECOND SESSION, APRIL 25 — 9 A. M. 

Present as before. 

The Secretary presented a report on the vaccination of one hundred 
and twenty-three students of Starling Medical College, as performed by 
Dr. Hoover and himself. 

On motion of Dr. Hoover the Secretary was instructed to increase 
the supply of vaccine virus kept on hand. 

An application was presented from th« authorities of Nelson ville for 
approval of the source of public water supply and outlet of their sewerage 
system about to be introduced. 

On motion of Dr. Hoover it was voted to hold the June meeting in 
Canton. 

The Secretary presented a report of an inquiry in re consumption in 
Ohio, embracing a resume of cases due to contagion, as reported by 
physicians; and also a circular on the Prevention of Consumption, 
intended for general distribution. 

Dr. Kahle moved that the report be received, and the circular adopted 
and printed for distribution. Carried. 

On motion of Dr. Kahle it was voted to prepare an additional circular 
containing matter selected from the Secretary's report showing the con- 
tagiousness of the disease. 

On motion of Dr. Kahle the Secietary was instructed to make an 
inquiry as to the prevalence of consumption in public institutions, and 
prtcautions taken to prevent contagion. 

Mr. Hartzell moved that the circular on Prevention of Consumption 
be placed in proper shape for distribution in the public schools. Carried. 

No further business presenting, the Board adjourned. 



JUNE MEETING. 

A regular meeting of the State Board of Health was held at the 
Hurtord Ilouse, Canton, Ohio, June 13 and 14, 1894. 

Present : Professor Nelson, in the chair, Mr. Hartzell and Drs. 
Ploover, Stanton and Kahle. 

A telegram from Dr. Miller, of Cleveland, was read, stating that he 
was unable to attend. 

On motion of Dr. Hoover it was voted to dispense with the reading 
of the minutes of the last meeting. 

The Secretary presented his quarterly report, which on motion of Dr. 
Hoover was received. 



24 ANNUAL REPORT 

QUARTERLY REPORT OF THE SECRETARY. 

Mr. President : I beg leave to submit the following report : 

One hundred thousand copies of a circular on the Prevention of 
Consumption, adopted at the April meeting, were printed, and most of 
them have been distributed. Copies were sent to all physicians in Ohio, 
to superintendents of schools, to the press, and to municipal and town- 
ship boards of health. 

The circular met with a very gratifying reception. It was published 
entire in a number of newspapers, and also received favorable editorial 
comment in many instances. As the result of press notices hundreds of 
requests for the circular, many of them from residents of other States, 
have been received. 

The following letter relative to the circular has just been received 
from Dr. Lee, of the Pennsylvania board, with copies of resolutions in 
regard to tuberculosis, adopted by that board, which I will also read : 

Philadelphia, June 6, 1894. 
Dk. C. O. Pbobst, Secretary State Board of Health, Columbus, Ohio : 

Dear Doctor : Accept my thanks for your -various valuable circulars on the sub- 
ject of Tuberculosis. There can be no question that they will result in great good, and 
we may ask the privilege of adopting certain of their suggestions for our own state. I 
send you resolutions adopted by our Board at its last meeting, referring to the same 
subject. 

Yours very truly, 

(Signed) Benj. Lee, Secretary. 

Resolved, That this Board considers the evidence in favor of the doctrine of the com- 
municability of tuberculous diseases, and especially of that form known as consumption 
of the lungs, to be of so convincing a character as to demand recognition by sanitary 
authorities ; and therefore, 

Resolved, That tuberculosis (including consumption of the lungs) be added to the 
list of communicable diseases dangerous to the public health, in the Eegulations of this 
Board ; and further, 

Resolved, That this Board strongly recommends to all local boards of health, that 
they require returns of tuberculosis, when it has reached the infective stage, from all 
physicians and householders, in the same manner that returns of other infectious dis- 
eases are now required. 

A circular letter was sent to the superintendents of State institutions, 
county infirmaries, and children's homes, asking for the following infor- 
mation: The number of deaths from consumption during the past five 
years, number during 1893, number of cases on hand, and precautions to 
prevent contagion. 

Answers have not been received from any of the State institutions. 
Fifty infirmaries reported fifty-four deaths from consumption during 1893. 
Very few could give the number for the past five years, as no record is 



OHIO STATE BOARD OF HEALTH. 2$ 

kept. No epecial precautions are taken in any of them to prevent spread 
by contagion. 

I received an invitation to address the Infirmary Directors' Associa- 
tion, which met in Akron June 7, and presented a paper on " The Pre- 
vention of Consumption in Infirmaries." Mr. Hartzell, who was in 
Akron on that day, attended the meeting with me, and also, by request, 
addressed the meeting. I had also the honor to present a paper before 
the Ohio State Medical Society at its annual meeting held in Zanesville, 
on May 16, on " The Prevention of Tuberculosis." 

The circular relative to railway sanitation has been sent out, and 
some of the roads have furnished reports showing that the Board's sug- 
gestions are being enforced. 

The resolution adopted by the Board relative to more efiective teach- 
ing of hygiene in medical colleges, was printed and a copy sent to each 
medical examining and licensing board, and to each State board of health 
in the United States. It was also sent to all the sanitary journals in the 
United States, and was printed in the columns of several with favorable 
comment. A number of letters, commending the Board's action, were 
received from the secretaries of examining boards and State boards of 
health. 

The following letter was received from the health ofiicer of Rendville : 

May 3, 1894. 
Dr. C. O. Pkobst, Secretary : 

Dear Doctor: The contents of this jar, which is a sediment cf cofiee from which 
six of Mr. Joseph Limity's family were severely poisoned Tuesday morning May 2. 

I am requested by the mayor of Eendville to send this jar with contents to you, and 
request that you have the State chemist make an analysis, and report to my address. 

Below are the symptoms that the patients, who used the coffee, had, viz. : Fever, 
burning pain in the epigastrium, stomach swollen, violent vomiting, tenesums, burning 
pains at the arms, muscular cramps in the legs, severe headache, intense thirst, dry, hot 
skin, small rapid pulse, anxious, pinched countenance, eyes suffused and smarting, 
tongue dry and furred, nervous twitching, with a perfectly clear mind. 

(Signed) J. S. Sessoms, M. D. 

P. 8. Please let me hear from yon at an early date. 

I wrote for further particulars, and received a second letter, as follows : 

May 7, 1894. 

Dear Doctor: Replying to your request, was called to see Joseph Limity's 
(Cora Lamida) family, May 2, where I found six persons of the family dangerously 
sick. I learned from the nurse that they were all sick while at breakfast. All who 
drank the coflee were taken instantly sick, and those who did not drink any coffee, but 
partook of the other food, escaped being sick while, none who drank the coffee escaped 
being sick. I then took some of the coffee and gave it to the house dog, and in a short 
time it had all the symptoms of a very sick little animal, while the eggs, meat and bread 
did not have any ill effects on it whatever. 

This coffee was bought of David Wells, and manufactured by the Lion Coffee 
Company. 

Yours truly, 

(Signed) J. 8. Sessoms, M. D. 



26 ANNUAL REPORT 

I then submitted the coffee grounds to Professor Howard for analysis, 
who reported as follows : 

Columbus, O., May 16, 1894. 
Db. C. O. Probst, Secretary Ohio Slate Board of Health : 

Dear Sir: I have examined the coffee grounds contained in fruit jar and received 
from you, with the following results : The examination was directed to the discovery of 
alkaloidal and metallic poisons. Alkaloidti were found to be absent. Compounds of the 
following metals were found to be absent : Mercury, copper, bismuth, lead, antimony 
and tin. Arsenic as arsenious oxide was present. 

Weight of coffee grounds, liquid and jar 737 gm. 

Weight of jar , 405 gm. 

Weight of coffee grounds and liquid 332 gm. 

Taken for analysis , 65 gm. 

Arsenic sulphide obtained, calculated as arsenic oxide .4174 gm. 

Present in entire contents, by calculation 2.1319 gm. 

Weight in grains 32.9 grains. 

Arsenic oxide in solid state at bottom of jar, .1755 gm = 2,7 grains. 

Total arsenic oxide present 35.6 grains. 

Respectfully submitted. 

(Signed) Curtis C. Howard. 

Copies of the correspondence and of the chemical analysis were sent 
to the prosecuting attorney of Perry county with the request that the 
matter be investigated. 

As special matters I have to pre=ent a report on the sanitary condi- 
tion of Uhrichsville, and of the investigation of an alleged nuisance at 
Woodsfield, Monroe county. 

Reepectlully submitted. 

C. 0. Probst, Secretary. 

Drs. Hoover and Probst, commiitee, presented a report of an inj'pec- 
tion of the National Vaccine Establishment at Washington, I). C. On 
motion of Dr. Kahle the report was received. 

Dr. Stanton moved that publication of the Monthly Sanitary Record 
be temporarily discontinued, and that the Secretary be instructed to notify 
all subscribers and others to whom the journal has been sent, that publi- 
cation wag suspended on account of a reduction in the appropriation 
granted the Board. Carried. 

Dr. Stanton moved to^reconsider the question. Carried. Dr. Hoover 
moved to amend as follows : 

That a committee be appointed to confer with the Emergency Board 
and request authority to create a deficiency for an amount sufficient to 
continue the publication of the Monthly Sanitary Record, and that on 
failure to secure a permit to create a deficiency, publication be suspended. 



OHIO STATE BOARD OF HEALTH. 27 

Dr. Stanton accepted the amendment. 

The motion as amended was then carried. 

The committee on sewerage and water supplies reported on the outlet 
of the sewerage system proposed for the village of Nelsonville. 

On motion of Dr. Kahle the report was received, and the recommend- 
ations of the committee approved. 

The same committee submitted a report on the proposed water supply 
for Nelsonville. On motion of Dr. Stanton the report was received and 
the recommendations of the committee approved. 

On motion of Dr. Stanton it was voted to appoint a committee to 
report at the next meeting on a uniform plan of procedure in all cases 
where the Board is called upon to approve sources of proposed public 
water supplies or outlets of sewerage systems. 

On motion of Dr. Kahle the Secretary was instructed to consult the 
Attorney General in regard to the legality of bonds issued to build water 
works or sewerage systems which have not been approved by the State 
Board of Health, as required by Section 2 of an act of March 14, 1893, as 
amending the act to create a State Board of Health. Also to secure the 
advice of the Attorney General as to the steps to be taken by the Board in 
regard to cities and villages that have established water works or sewerage 
systems in violation of the provisions of said act. 

Professor Nelson moved to proceed with the election of oflScers. 
Carried. 

Professor Nelson nominated Dr. Byron Stanton for President for the 
ensuing year, and moved that the Secretary be instructed to cast the bal- 
lot of the Board for Dr. Stanton. Carried. The Secretary reported hav- 
ing performed this duty, and Dr. Stanton was declared unanimously 
elected. 

Dr. Kahle nominated Dr. Wise for Vice-President. Dr. Hoover moved 
to instruct the Secretary to cast a ballot for Dr. Wise. The Secretary 
reporting this duty done, Dr. Wise was declared elected. 

Dr. Kahle moved that when members were unable to attend Board 
meetings, they be instructed to telegraph the Secretary. Carried. 

Dr. Kahle moved that the Secretary and two members, to be appointed 
by the President, be delegated to represent the Board at the meeting of 
the American Public Health Association in Montreal, in September. 
Carried. 

Adjourned to meet at 8:30 a. m. the 'following day, to inspect the 
sewage disposal plant, water works and hospital at Canton. 



28 ANNUAL REPORT 

OCTOBER MEETING. 

A regular meeting of the State Board of Health was held in Colum- 
bus at the office of the Secretary, October 24 and 25, 1894. All members 
were present. Professor Nelson occupied the chair. 

The minutes of the last meeting were read and approved. 

Professor Nelson then resigned the chair to Dr. Stanton, who was 
elected President at the June meeting. 

The Secretary presented his quarterly report, which was approved. 

quarterly report of the secretary. 

Mr. President : 

I have the honor to submit the following report of operations since 
the meeting of the Board in June. 

The matter of creating a deficiency in order to continue the publica- 
tion of the Monthly Sanitary Record, was laid before the Emergency 
Board, but the request was denied. 

When the change in postal laws was amended, admitting bulletins 
of State boards of health as second class mail matter, I wrote to each 
member of the Board in regard to issuing a monthly bulletin. All of the 
members favored it. The firm which printed the Record has offered to 
print three thousand (3,000) copies of a monthly, eight-page bulletin 
without cover, but with an extra sheet for mortality tables, for $52.00 per 
month. Without the extra sheet for mortality tables, $20.00 per month. 

I prepared the matter for an October bulletin, but, by advice of Dr. 
Hoover, have held it so that the question of issuing a bulletin could be 
considered at this meeting. 

The following are titles of special reports to be submitted at the 
pleasure of the Board : 

1. Sewage Disposal at Oberlin. 

2. Sewerage for Athens. 

3. Sewerage for Marysville. 

4. Water Supply of Bowling Green. 

5. " Lancaster. 

6. Nuisance at Alliance. 

7. " Bellefontaine. 

8. " Vinton. 

9. Diphtheria at Lorain County Infirmary. 

10. " Perrysville. 

11. Typhoid Fever at Bradner! 

12. " Pt. Pleasant. 

13. " Mansfield. 

14. " Medina County Infirmary. ■ 



OHIO STATE BOARD OF HEALTH. 29 

Dr. Hoover of the finance committee submitted a report of receipts 
and disbursements to date. 

Dr. Stanton submitted a report of an investigation of an alleged 
nuisance at Arlington Heights. On motion of Dr. Hoover the report 
was received. 

Dr. Kahle and Professor Nelson, special committee, presented a re- 
port on the proposed additional water supply of Lima. On motion of 
Dr. Miller the report was approved. 

Mr. Hartzell, Professor Nelson and the Secretary, a special com- 
mittee, presented a report on the proposed outlet for sewer district No. 
2 of Ashtabula. On motion of Dr. Miller the report was approved. 

Professor Nelson presented a report on the proposed water supply of 
Napoleon. On motion of Dr. Miller the report was approved. 

Dr. Hoover oflfered the following resolution and moved its adoption : 

Resolved, That the suspension of the publication of the monthly bulletin be con- 
tinued indefinitely, on account of the lack of funds. 

A yea and nay vote being called for, resulted in four votes in the af- 
firmative and three in the negative ; so the resolution was declared 
adopted. 

Adjourned to 9 a. m. the following day. 



OCTOBER 25, 1894. 

The Board convened at 9 a. m,, all members being present. 

Communications were presented from Wooster, requesting approval 
of a proposed water supply for that city. 

On motion of Professor Nelson the matter was referred to the Presi- 
dent for action. 

The President announced the following committees for the year 
1894-5 : 

Hygiene of Public Institutions. 
B. Stanton, Chairman, T. C. Hoover, The Secretary. 

Epidemic and Epidemic Disecises and Quarantine. 
S. P. Wise, Chairman, W. T. Miller, The Secretary. 

Hygiene of Railways and Occupations, 
T. C. Hoover, Chairman, Josiah Hartzell, R. D. Kahle. 

Hygiene of Schools. 
E. T. Nelson, Chairman, W. T. Miller, E. D. Kahle. 



30 ANNUAL REPORT 

Adulteration of Foods, Drinks and Drugs. 
W. T. MiLLEK, Chairman, R. D. Kahle, E. T. Nelson. 

Vital Statistics. 
S. P. Wise, Chairman, B. Stanton. 

Especial Sources of Danger to Life and Health. 
R. D. Kahle, Chairman, S. P. Wise, Josiah Habtzell. 

Water Sources, Sewerage and Drainage. 
E. T. Nelson, Chairman, Josiah Hartzell, The Secretary. 

Diseases of Animals. 
Josiah Hartzbll, Chairman, S. P. Wise, T. C. Hoover. 

Finance. 

T. C. Hoover, Chairman, W. T. Miller, E. T. Nelson. 

Professor Nelson moved that the President and Secretary be required 
to take into consideration the advisability of sending to each member of 
the Board a brief monthly report of the work being done. Carried. 

A communication was presented from Mr. T. .J. Mulvihill, an under- 
taker of Cincinnati, requesting permission to remove the remains of 
thirteen persons buried in St. Joseph's Cemeterj^ near Cincinnati, to 
Reading, Hamilton county, Ohio. One of these persons died of small- 
pox ; the cause of death of the others was unknown. 
On motion of Dr. Miller the request was refused. 
The Secretary reported that he had been informed that the Ashland 
County Infirmary was in a bad sanitary condition. On motion of Dr. 
Miller the matter was referred to the committee on hygiene of public 
institutions. 

The Secretary submitted a proposition in favor of publishing a 
quarterly sanitary bulletin, provided the proceedings of the annual 
meetings with local boards of health could be included therein. 

Dr. Miller moved a reconsideration of the vote on the resolution 
offered by Dr. Hoover. Carried. 

Dr. Miller moved to amend the resolution so as to provide for the 
publication of a quarterly bulletin. 

Mr. Hartzell moved as an amendment to the amendment, that the 
publication of a quarterly bulletin be referred to a special committee with 
power to act, consisting of Dr. Hoover and the Secretary. 
The resolution, as amended, was adopted. 

Professor Nelson offered the following resolution, which was unani- 
mously adopted: 



OHIO STATE BOARD OF HEALTH. 3 1 

Resolved, That the thanks of this Board are due, and are hereby tendered, Hon. 
Joseph E. Washington, Member of Congress from Tennessee, for his successful efforts in 
securing low postage rates for publications of State Boards of Health. 

On motion of Dr. Kahle it was voted to hold a joint meeting of the 
State and local boards of health, the program to be prepared by the 
President and Secretary. 

Mr. L. E. Chapin, C, E , of Canton, Ohio, appeared before the Board 
and presented plans showing proposed sewerage system of Marietta and 
of Alliance, and proposed waiter supply of Louisville. 

On motion of Dr. Hoover, duly seconded, it was voted to approve the 
plans for sewerage of the city of Marietta, as submitted by Mr. L. E. 
Chapin, consulting engineer, subject to the following change: i. e., that 
the outlet sewer for sewer district No. 1 should be merged into the outlet 
sewer for sewer district No. 2, said outlet being located at the foot of Post 
street. The Secretary was instructed to certify upon the plans their 
approval by the Board. 

Mr. Hartzell moved to approve the plans for a watejr supply for 
Louisville. 

Dr. Hoover moved to amend by adding " If deemed advisable after a 
personal examination by the Board." 

The motion, as amended, was approved. 

On motion of Dr. Hoover the standing committee on water sources, 
sewerage and drainage was instructed to prepare forms and specifications 
to be used in submitting proposed water supplies and outlets of sewerage 
systems to the Board for approval. 

On motion of Dr. Hoover it was voted to request the council of the 
city of Alliance to have complete plans prepared and submitted to the 
Board for approval, showing proposed methods for disposing of its sewerage, 
and for its purification before turning it into the Mahoning river. 

Mr. Chapin presented the matter of the alleged pollution of the 
Hocking river by sewerage from the Athens Asylum for Insane. No 
action was taken. 

The Secretary presented matters to be included in the annual report 
for 1894. The report was approved. 

A number of communications, with reference to which action had 
already been taken by the Secretary, were presented. 

No lurther business presenting, the Board adjourned. 



32 ANNUAL REPORT 

SPECIAL REPORTS. 



CONTAGIOUS DISEASES. 

1. Report on Diphtheria at Austinburg. 

2. Report on Diphtheria at Lorain County Infirmary. 

3. Report on Diphtheria near Perrysville. 

4. Report on Typhoid Fever at Bradner. 

5. Report on Typhoid Fever at Point Pleasant. 

6. Report on Typhoid Fever at Mansfield. 

7. Report on Typhoid Fever at Medina County Infirmary. 

SEWERAGE. 

1. Report on Sewerage for Athens. 

2. Report on Sewerage for Ashtabula. 

3. Report on Sewerage for Hamilton. 

4. Report on Sewerage for Marietta. 

5. Report on Sewerage for Marysville. 

6. Report on Sewage Disposal at Oberlin. 

7. Report on Sewerage for Warren. 

WATER SUPPLIES. 

1. Report on Water Supply for Bowling Green. 

2. Report on Water Supply for Lancaster. 

3. Report on Water Supply for Lima. 

4. Report on Water Supply for Napoleon. 

5. Report on Water Supply for Wooster. 

NUISANCES. 

1. Report on Nuisance at Alliance. 

2. Report on Nuisance at Arlington Heights. 

3. Report on Nuisance at Bellefontaine. 

4. Report on Nuisance at Vinton. 

5. Report on Nuisance at Woodsfield. 

MISCELLANEOUS. 

1. Report on Consumption. 

2. Report on Small-pox and Vaccination. 

• 3. Report of Inspection of National Vaccine Establishment at 
Washington, D. C. 

4. Report of Inspection of Woman's National Relief Corps Home. 



OHIO STATE BOARD OF HEALTH. 33 

5. Report on Sanitary Condition of East Palestine. 

6. Report on Sanitary Condition of Uhrichsville. 

7. Report on Sanitary Condition of School House at Bryan. 

8. Report of Delegate to Montreal Meeting of the American Public 
Health Association. 



REPORT ON DIPHTHERIA AT AUSTIXBURG 

BY THE SECRETARY. 

On December 12 I was called by telegram to Austinburg, Ashtabula 
county, on account of diphtheria. 

November 29 a young girl in the family of C. A. Alvord was taken 
sick with diphtheria, and two other children in the same family subse- 
quently developed the disease. 

The following day, Thursday, two children in the family of Dr Ells- 
worth, aged five and seven, were taken sick with the disease ; one died on 
the following Sunday evening. On the next day, Monday, his wife was 
taken down with the disease. She had a severe attack but recovered. A 
third child in the family, aged two years, was removed on the day the 
elder children were taken sick, to a family in the village where there were 
no children. ~ This child was also taken sick with diphtheria a few days 
later, and was buried on the day of my visit. 

Thursday, November 30, a young lady in another family was taken 
sick and died on the toUowing Sunday. On December 6 her mother de- 
veloped diphtheria but recovered. December 3 a child of six years, in an- 
other family, took the disease but recovered. 

Bearing on the origin of the disease, the following facts were learned : 

Some two weeks prior to the outbreak in the village, Dr Ellsworth 
was called to see a diphtheria patient in the country. Being fearful of car- 
rying the disease to his children, he sent his wife and children to her 
parent's home ten miles away. On dismissing his diphtheria case, the doc- 
•or claims that he thoroughly disinfected his clothing and then put on a 
lew suit of clothing, leaving the old one in the garret. Ten days later he: 
ent for his family, and wiihin two or three days after their arrival the^ 
older children were stricken with diphtheria. It is not known that these 
children were exposed to the cast ofi suit of clothing. 

Tue first case, the young girl taken sick November 29, regularly got 
milk from Dr. Ellsworth. During the time Dr. Ellsworth attended the 
diphtheria case in the country he milked his cow and cared for the milkand 

;^ ST. B H. 



34 ANNUAL REPORT 

two or three of the families in which diphtheria occurred, used this milk-hut 
as these cases did not occur until two weeks alter the doctor had discharged 
his diphtheria case, I do not think it probable that he directly infected the 
milk. 

The diphtheritic virus was undoubtedly carried to his house, and it 
is possible that they gained lodgment there and subsequently infected the ^ 
milk, which was kept in the house. I doubt the fact of this having been 
the medium of communication, though this theory was held by many of 
•the residents. 

The trustees of the township (the village is not incorporated), had 
organized a board of health previous to the outbreak, and had elected Mr. 
H. G. Shipman health officer. The school in the village had been closed, 
but on the outskirts is located the Grand River Institute, and the mana- 
gers had determined to open school on the 12th of December. The town- 
ship board of health, not knowing how to deal with the matter, tele- 
graphed for me to come. A consultation was held with the township 
board and managers of the Institute. There are usually one hundred 
and fifty to two hundred students attending the Institute, the majority 
of them being from the surrounding country. About forty had already 
arrived. 

I found that the case of diphtheria had not been strictly quarantined 
as regards adults of families in which there were cases of the disease, and 
that one of the Institute pupils had been indirectly exposed to diph- 
theria the day I was there. It was agreed that the Institute should re- 
main closed for one week, and longer if there was further extension of the 
disease; and that students already there should be prohibited from going 
into the village until diphtheria disappeared. 

I have just received the following letter from Dr. Ellsworth giving 
additii^nal information concerning the outbreak : 

AusTiNBURG, Ohio, January 22, 1894. 
Dk. C. O. Probst, Golumhus, Ohio : 

Dear Do(;tor : Upon inquiry to-day I find that C. A. Alvord's daughter was 
taken sick on November 28, instead of 29. My two older boys were taken sick on the 
30th, the youngest on December 6. 

I am safe in saying that the Alvord children had none of them been to my house 
after milk for thirty days prior to date of sickness. She had, in company with many 
other children, been to my office to get vaccinated, perhaps ten or fifteen days before 
sickness. 

As to milk, Alvord's wife told me that their youngest children drank very much 
more than she did and they were not taken sick for four or five days after she was. 

The same was true at our house. The youngest boy drank much more milk than 
the others and was taken sick last. 

School was not opened till January 2. There were three cases developed up near 
4he Institute buildings after you were here; I think it was about Wednesday or Thurs- 



OHIO STATE BOARD OF HEALTH. 35 

day after. Two in the family of a colored woman, who had been washing for the family 
of the principal and several others in the village, including Shephers' and Peirs' family, 
who lost a fifteen year old girl. One of the colored children died. 

Altogether there have been eleven cases, possibly twelve, in the village, of whom 
seven died. 

Nothing more is known as to its origin. 

Yours truly, 

W. O. Eliswobth. 



REPORT ON DIPHTHERIA IN THE LORAIN COUNTY 

INFIRMARY. 

BY THE SECRETARY. 

The newspapers, September 10, reported an outbreak of diphtheria 
in the Lorain County Infirmary. I wrote the superintendent on that 
date and in reply he stated that there had been seven cases and one death. 
He stated that the attending physician. Dr. McLean, ofElyria (our health 
officer) was of the opinion that defective plumbing had caused the out- 
break. This was being remedied in the main building, but nothing was 
' eing done in the department for the insane, although one case came 
from there. He requested me to come up and make an investigation. 
I stated in reply, that Dr. McLean could be trusted to look after the cases 
and that I did not consider a visit necessary. I received a second letter 
trom the superintendent, and also one from Dr. McLean, urging me to 
come in order that the county commissioners might be induced to make 
necessary repairs to the plumbing in the building for the insane. 

I went there on September 17, and visited the institution with Dr. 
McLean. There had been no recent admission by which diphtheria 
might have been introduced, and the first case was an old inmate. If 
emanations from foul drains can cause diphtheria, the cause was there. 
Extensive repairs were being made in the plumbing of the main build- 
ing, but I was still able to see that it had been in an exceedingly bad 
condition, due entirely to faulty construction. There were no traps in 
the fixtures, nor in the drains, and no ventilation. The soil pipe only 
extended a little above the highest fixture. Many of the joints between 
waste pipes and the soil pipe were broken, permitting the escape of sewage 
into the building. 

In the insane department the plumbing was even worse than it had 
been in the main building. Hopper water closets were placed in • the 
sleeping rooms of the inmates, who were thus, at all times, exposed to 
the foul air ascending from the drains. No changes, I was informed, 



36 ANNUAL REPORT 

were contemplated in the plumbing of this part of the building. Upon 
my return I sent the following communication to the commissioners of 
Lorain county : 

To the Commissioners of Lorain County, Elyria, Ohio : "~ 

Dear Sirs: The attention of our Board has been called to the recent outbreak of 
diphtheria in the Lorain County Infirmary, and at the request of the superintendent, I 
visited that institution on the 18th instant, for the purpose of looking into its sanitary 
condition. 

Eight cases of diphtheria, with one death, have recently occurred in the infirmary. 
The conclusion that these cases were due to defective plumbing is undoubtedly correct, 
and your prompt action in having a thorough overhauling of the plumbing in the main 
building is to be commended. An examination of the plumbing in the building for the 
insane shows it to be, if anything, in worse condition than that in the main building. 
It is evident that this building is at all times permeated with foul gases from the sewer, 
as the plumbing is so constructed, or in such bad repair, that there is nothing to prevent 
this. 

One of the cases of diphtheria was an inmate of the insane department. 

I was informed that it is not your present intention to repair the plumbing in this 
buildin". To leave it in its present condition is to invite another outbreak of disease, 
and a contagious disease am Dng the insane inmates will threaten all the others. You 
will have accomplished little real good with the repairs now being made unless tb.- 
plumbing throughout all the buildiugj is placed in a safe condition. We trust that you 
will have this done at once. 

Aside from the plumbing, I found the infirmary clean and in a good sanitary condi- 
tion, speaking well for the present management. One other matter, however, should be 
brought to your attention, and that is, the lack of proper means of escape from the build- 
ing for the insane in case of fire. It might easily occur that the one exit now provided 
would be cut off, in which case it would be impo-sible for the inmates to escape. To 
avoid the possibility of such a calamity a fire escape should be provided. 

Hoping the improvements above indicated will be promptly made, I have the honor 

to be. 

Very respectfully, 
(Signed) C. O. Probst, Secretary. 

Dr. ^McLean, under date of October 15, informs me that nothing ha-, 
been done to improve the plumbing in the building for insane. The 
commissioners, however, will provide a fire escape for this building. Nn 
other cases of diphtheria have occurred in the institution. 



REPORT ON DIPHTHERIA NEAR PERRYSVILLE. 

BY THE SECRETARY. 

The board of health of Greene township, Aghland county, sent an 
urgent request for the State Board to come to their aid in suppressing 
diphtheria. They reported that they were having great difficulty in en- 
forcing quarantine, and there was fear that the disease would spread to 
the village of Perrysville. 



UHIO bTATE BOARD OF HEALTH. 2)7 

I went to Perrysvilie August 21, and at my request the President 
appointed Dr. Wise to accompany me. We found that malignant diph- 
theria had developed in a family named Ehrhart, who lived about a mile 
and a half from the village. As the township board of health had not 
been long organized, and as this was the first case of contagious disease 
they had had to deal with, they desired to counsel with the State Board 
of Health. 

The president of the township board, Mr. Mower, and the township 
health officer, Dr. Covert, drove with us to the house of Mr. Ehrhart. The 
family consisted of Mr. and Mrs. Ehrhart and eight children. Three of 
these had died of diphtheria; three were sick, two of them not expected 
to live, and the other two children had had the disease but recovered. Mrs. 
Ehrhart had just contracted the disease. She was in daily expectation of 
confinement. A female nurse from Mansfield, employed by the board of 
health, and a male relative from Mansfield assisting the nurse, were also 
in the house. The board had also employed a physician. Dr. Steward, of 
Mansfield, and was furnishing the family with food and supplies. The ' 
house had been placarded, but the card had been torn down by someone. 
Another card was put up ; but it was reported that quarantine was being 
violated, and this had caused great public excitement, owing to the ex- 
treme malignancy of the disease. It was to get advice on how to maintain 
quarantine and enforce their orders that the State Board was called in. 
Proper instructions were given them ; and we also endeavored to impress 
relatives living near by with the fact that quarantine orders must be 
strictly obeyed. 

As it was considered highly dangerous for a woman to be confined 
amid such surroundings, we advised that the mother be removed ; and if 
nothing better could be had, that a tent be provided for her accouchement. 

We were unable to learn positively the origin of the disease. The 
house, the nurse reported, was in a very filthy condition, and that was 
possibly a factor in increasing the malignancy of the disease. 

We were very much pleased with the desire manifested by the board 
of health to employ all necessary measures for the suppression of the 
disease without regard to expense. 

September 1, Dr. Covert reported that two other children in the Ehrhart 
family had died of diphtheria, making five deaths from the disease in this 
family. The township board furnished tents, bedding and clothing, and 
the remaining members of the family were removed to the tents and the 
house vacated. The house was then thoroughly disinfected, and no other 
cases occured. 

This affords a striking example of the good that is being accomplished 
by our township boards of health. 



38 ANNUAL REPORT 

REPORT ON TYPHOID FEVER AT BRADNER. 

BY THE SECRETAKY. 

I was called to Bradner October 5, on account of t3'phoid fever. 
Bradner is a village of about 800 inhabitants, in Wood county, on the 
Columbus, Hocking Valley and Toledo Railroad, a few miles north of 
Rising Sun. 

Early in September a case of typhoid fever occurred in the village. 
This was followed by others until, at the time of my visit, sixteen cases 
with three deaths had occurred. 

The village had been without a board of health, but one was organized 
a few days before I was summoned there. The health officer, Dr. Furste, 
took me to each of the houses in which cases of typhoid fever had 
occurred. The surface of the village is very flat, so that natural drainage 
hardly suffices to remove surface filth. Near the center of the village the 
rock — a porous limestone formation, is almost uncovered, and it is 
necessary to blast cellars in the rock. This rock is very porou* Dr. 
Furste informed me that when blasting his cellar a rain came up which 
filled the cellar. In an hour's time after the rain ceased the water had 
all disappeared. 

There are a few privy vaults used, but as a rule fecal matter is simply 
deposited on the surface. Wells are drilled into the rock fourteen to 
sixteen feet and piped for a few feet only. It will be seen that rain 
falling on the surface must gather large quantities of filth, and that there 
is not sufficient soil on top of the rock to filter the water that reaches the 
wells. 

All but two or three of the cases occurred in the southern part of the 
village. There is a decided dip to the rock from the center of the village 
south, and eight to ten feet of earth is found on top the rock. This 
should afford purification to the water filtering through it, but the rock 
inclination probably causes the water falling in the central part of the 
village to flow south over its surface, and into the wells. 

The village bears the history of yearly cases of typhoid fever, and t 
think it is unquestionably due to the pollution of the wells. Some of the 
citizens were of a different opinion, at least as regards the present out- 
break. Southeast of the village, about a half mile,' a skunk farm is 
located. Several persons are united in the raising of skunks for their 
pelts. It was claimed that dead animals were carried to this farm, the 
Bkunks feeding upon them. The stench, from the dead animals 1 suppose, 
was alleged to be often very perceptible in that part of the village where 
the fever cases occurred. The health officer and myself attempted to find 



OHIO STATE BOARD OF HEALTH. 39 

this skunk farm, but were unsuccessful, though I must confess our search 
was conducted with a great deal of caution. 

A meeting of the local board of health was called, and measures for 
preventing other cases of the disease fully discussed. I advised the Board 
to take immediate steps for the removal of surface filth and the cleaning 
of privies. Also, that they urge the people to use only boiled water until 
the fever should disappear. I also advised them to gradually require all 
houses to be provided with dry earth closets. 

You will remember that a year ago the village of Rising Sun, near 
Bradner, suffered severely from typhoid fever. Also, that for some years 
Rising Sun has suffered from the disease each fall. 

The geological conditions there are very similar to those at Bradner, 
the village being in large part built on superficial rock. I advised the 
board of health of Rising Sun, at the time of their epidemic, to abolish all 
privy pits, and to require the use of tight boxes above ground, i. e., the 
dry earth system. Also, that the surface of the soil should be kept free 
from all kinds of filth. 

For the first time in many years Rising Sun has remained free from 
typhoid fever, a remarkable fact, considering its prevalence in the 
neighborhood. In answer to a letter of inquiry, the mayor, under date 
of October 18, informed me that there has been but one case of typhoid 
fever in Rising Sun this year, and that was a case imported from Elmore. 
Boiled water was not being used for drinking, as I had been informed, 
only one family resorting to this precaution, but great attention had been 
paid to keeping the soil free from filth. The mayor says: "As regards 
vaults we succeeded in getting them all replaced by tubs as you recom- 
mended; after we made five arrests. It made matters a little warm, but 
they had to come to it. We do not allow any garbage, swill or offal from 
any source whatever to be thrown on the ground. It is put into barrels 
or other receptacles and removed from the town." 

With typhoid fever at Bradner, five miles away, and also in the 
country around the village, the conclusion is irresistible that their present 
freedom from the disease is due to these precautionary measures enforced 
by the board of health. The future of this village as regards typhoid 
fever will be of much interest. 



40 ANNUAL REPORT 

REPORT ON TYPHOID FEVEPv AT POINT PLEASANT. 

BY THE SECRETARY. 

Several communications were received from residents of Point 
Pleasant, Valley township, Guernsey county, reporting typhoid fever 
prevailing as an epidemic. The township board of health was notified 
to look after the sanitary condition of the village, and especially the water 
supply. Printed circulars on the prevention of typhoid fever were sent 
for public distribution. Complaint was made later that the township 
board had taken no action, and I was urged to come to the village. 

Dr. Knackley, of Point Pleasant, a member of the school board, 
reported that he doubted the advisability of opening the schools on 
account of the fever, and also urged me to come. I went on September 
6. The village contains probably 300 inhabitants. It is located on the 
M. & C. Railroad, at the foot and on the side of a large hill. Dr. Bown, 
township clerk, and Dr. Knackley are the only physicians there. With 
these gentlemen I visited the various houses in which typhoid fever had 
occurred. Dr. Bown was called to the first case, a young girl, April 13. 
About the same time a second case occurred in a child in a Hungarian 
family. No connection could be traced between these cases, and there 
was no community of water supply. Other cases followed until, at the 
time of my visit, twenty-two cases with three deaths had occurred. 

Standing near the school house, which is at the upper end of the 
village, it was possible to point out, in a comparatively small circle, all 
but two or three of the houses in which the disease had appeared. 
Flowing through this part of the village, past the school house, is a small 
run, dry, however, at this time. The school house privy had been built 
over this run so that the excreta would be washed away. This privy 
was recently moved. The run was very filth}'^, and, at night especially, 
gave rise to offensive smells. Most of the cases of fever had occurred in 
houses close to and on either side of this run, which is highly suggestive 
of its causal relation to the spread of the disease. There are but few privy 
vaults in the village. The privies are built without vaults, the excreta 
being deposited on the ground. As a result every dashing rain storm 
carries with it a greater or less amount of excremental filth to be 
deposited in the yards, and possibly to be washed into the wells of the 
houses lower down the hill Owing to the continued drought the wells 
were all low and many of them nearly dry. 

In the village of Hartford, about a mile from Point Pleasant, and in 
the same township, about twenty cases of typhoid fever had occurred 
some weeks earlier. There were no deaths. It is noteworthy that in this 



OHIO STATE BOARD OF HEALTH. 4 1 

village, after a local member of the township board of health, with the 
help of a sanitary officer, took steps to remove the filth and clean up the 
village, the disease entirely disappeared, though no change had been 
made in the water supply, and the wells had been steadily getting lower. 

In the afternoon I met the township board of health. Alter thoroughly 
discussing the matter the board agreed to employ a health officer and 
instruct him to visit each house in the village and have the privies, yards 
and all filthy places thoroughly cleaned. Also to have the ditch cleaned 
after the plentiful use of lime. 

The school board was notified not to open school until after the 
ditch had been cleaned. Also to provide a tight box for the privy, and 
provide for the frequent removal of the excrement. 

I urged that special attention be given to the water supply, that 
suspicious wells be closed, and the people urged to use only boiled water 
for drinking. 



REPORT OX TYPHOID FEVER AT MANSFIELD. 



BY THE SECRETARY. 



By request of the board of health of Mansfield I visited that place 
October 17. The object of m^- visit was to assist the local health author- 
ities in determining the cause of typhoid fever, which prevails there to 
a considerable extent. 

The history of the outbreak is briefly as follows: Mrs. Davis, who 
lives in a new addition facetiously called "Stumpfield"' by Dr. Craig, 
the health officer, because only recently the land has been cleared and 
many stumps are still standing, was taken with typhoid fever June 10, 
1S94. Mrs. Davis undoubtedly contracted the disease from her daughter 
who lived in the village of Washington, near Mansfield. Her case was 
called malarial fever, and the health authorities did not know of it until 
several weeks alter she was taken sick. This was the first case in that 
part of the city. There were no other cases until July 20, when her son 
was taken sick. He had also been to visit his sister in Washington. In 
August the disease b(gan to spread, and there were twenty cases in that 
month, nearly all in '" Scumpfield." Fiiteen cases were reported in Sep- 
tember, and seven in October up to the 7ih. In all there were fifty-nine 
cases reported, and we found three additional cases which h^ been called 
malarial fever. Ten deaths have occurred. Dr. Craig and myself, with 
the assistant health officer and sanitary policeman, spent two days looking 



42 ANNUAL KhPORT 

up the cause of the disease. We collected the history of thirty-two cases,. 
and Dr. Craig undertook to complete the list after I left. 

I have tabulated the facts recorded in regard to these thirty-two cases, 
giving name, age, sex, date of illness, water supply, milk supply, drainage 
and sewer connections, and exposure to other cases of the disease. 

At least forty of the cases have occurred in this one section. This 
part of the city is comparatively thinly settled, so that the houses are 
not close together. 

WATER SUPPLY. 

The disease occurred in four families where cistern water was being 
used. These cisterns did not leak, were protected from surface drainage, 
and apparently not liable to pollution. In one family where cistern 
water was used — the Davis family, the first case — the disease was 
imported. In the Bushy family, where five cases occurred, they occasion- 
ally used water from the Worrels' well, a deep, drilled well, before the first 
case occurred, and altogether afterwards. Mrs. Pitchie, who used cistern 
water, visited Ida Bushy when she had the fever, but did not remember 
ever to have drank water or other beverage there. 

In seven families water from dug wells was used. We did not examine 
all of these wells. One case occurred where the patient always drank 
boiled water at home and artesian water at the place where he worked. In 
four families the water used was from drilled wells. These 
wells are all about eighty feet deep, with iron casing. In 
four families where well water was used we did not learn whether the 
water was from dug or drilled wells. In but two cases was hydrant water 
used, and in both there was a likelihood that well water had also been 
drank. It is to be borne in mind however, that nearly all the people in 
this district use well water. 

MILK SUPPLY. 

There were ten different sources of milk supply which exclude it as 
the cause. On the first day the milk from one dairyman was strongly 
under suspicion, and Dr. Craig and I made a careful inspection of the 
dairy. There was nothing to indicate that the milk was polluted, and, 
as stated, the various sources of supply would exclude the milk. 

There was but one house where cases occurred connected with the 
public sewer. Four or five of the houses have cellar drains connecting 
with a drain from the fair ground, but this is a tile drain, opening into a 
ditch, and does not receive drainage from privy vaults. 



OHIO STATE BOARD OF HEALTH. 43, 

In fifteen cases there was a history of Exposure to other cases, but five 
of these were in one house, three in another, three in another, and two 
in another. 

The soil is clay, and the site of most of the houses elevated. The 
usual plan for caring for excreta is by a vault lined with plank. So far 
I have not been able to reach any satisfactory solution of the cause of the 
trouble. 



REPORT ON TYPHOID FEVER AT MEDINA COUNTY 
INFIRMARY. 

BY THE SECRETARY. 

The superintendent of the Medina County Infirmary reported that 
typhoid fever had appeared in that institution and requested me to come 
there. As I had arranged to be in Bowling Green on August 27, I noti- 
fied him that I would visit him on the 28th, which I did. 

The superintendent, Mr. Zimmerman, gave me a full report of the 
cases of typhoid fever, of which there had been seven, with one death. 
Four of the patients were inmates of the infirmary, one an employe, and 
three were workmen engaged in the construction of a new infirmary build- 
ing. This building is near the old one. The old building for the insane 
had been torn down and the ground on which it stood had been excava- 
ted. The superintendent thought this had caused the outbreak of typhoid 
fever. 

The drinking water, at the time the cases developed, was obtained 
trom a dug well a few feet from the old building — that is the main build- 
ing. The water had become very low in the well, and it had been aban- 
doned some time before. The pump was left in the place, and one of the 
employes and one of the inmates who developed typhoid fever, after the 
well was abandoned for general use, were known to have used water from, 
it. About fifty feet from this well, immediately in front of the wash 
house, is an overflowing piped well. Water was used from this to some 
extent before the dug well was abandoned, but afterward was wholly de- 
pended upon. It was necessary to attach a pump to it to obtain this extra 
supply. The surroundings of this well were not of the best, and I gave 
instructions to have necessary improvements made. 

A careful study of the facts seemed to warrant the conclusion that 
the dug well was responsible for the cases of typhoid fever, and I directed 
the superintendent to remove the pump and abandon the well. 



44 ANNUAL REPORT 

It will be remembered that the Board made an investigation of this 
infirmary (Medina county) some time ago, and condemned it, recom- 
mending a new building. This is now being constructed. 

Under date of October 22, the superintendent reports that but one 
case of typhoid, fever has occurred in the infirmary since my visit ; a do 
mestic having taken the disease September 19. 



REPORT ON SEWERAGE OF ATHENS. 

BY THE SECRETARY. 

September 4, Mr. W. G, Clark, consulting engineer^ called at the office 
and presented plans showing the sewerage system to be constructed for 
Athens, and asked for the approval of the proposed outlet. Our President 
was here at the time and examined the plans. 

On the same date a letter was received from Hon. C. H. Grosvenor, of 
Athens, in regard to an alleged nuisance arising from the discharge of 
sewage from the insane asylum into the Hocking river. 

I was directed by the President to go to Athens, where I met Mr. 
Clark on the following day, and also the health officer. Dr. Alderman, who 
most kindly placed his services at our disposal. Work had already begun 
on the outfall sewer, but Mr. Clark stated in advance that the outlet would 
be changed if objections were made to it. The discharge is made into the 
Hocking river about 500 feet below a mill dam, which exists just below 
the east end of Mill street. There is a very good current of water at this 
point, and the sewage will be rapidly carried awf-y. There are no houses 
in the neighborhood, although some building has been done further down 
the river. The Hocking river below Athens is not the source of any pub- 
lic water supply. Should the question of sewage disposal come up in the 
future, land admirably adapted for filtration areas can easily be com- 
manded. It is probable, however, that the sewage would have to be lifted 
several feet, Mr Clark assures that this may be done automatically by 
the use of an electric motor, at a cost not exceeding one dollar per day, as 
the system is designed for sewage only. 

The following report was therefore made to the council of Athens : 

September 7, 1894. 
To the Mayor and Council, Athens, Ohio : 

Sirs : The proposed outlet of the system of sewerage for your village, as shown by 
plans prepared by Messrs. Clark and Chapin, consulting engineers, and submitted to the 
State Board of Health, as required by Section 2 of an act passed March 14, 1893, is 
hereby approved. 

Respectfully, 

(Signed) C. O. Probst, Secretary. 



OHIO STATE BOARD OF HEALTH. 45 

In the afternoon Mr. Cl^rk, Dr. Alderman and myself examined the 
river with reference to its pollution by sewage from the asylum. The 
river presented a fairly good appearance. No odor was perceptible from 
its banks or from a bridge which crosses it. There was a very slight cur- 
rent. Innumerable bubbles could be seen breaking over its surface, which 
I judged was due to the liberation of gases formed in the decomposition 
of organic matter in the water. 

We next v'site4 the asylum, and called upon Dr. Dunlap, the super- 
intendent. The sewage ot the institution is discharged through a part 
stone, part pipe, sewer, into the Hocking river some distance above the 
dam spoken of. This has been going on since the institution was estab- 
lished. There are now over one thousand inmates in the asylum. 

Dr. Dunlap gave assurance that he would favor such changes in the 
disposal of their sewage as would be recommended by the State Board of 
Health. There is apparently no land belonging to the asylum suitable 
for sewage filtration or irrigation, but suitable land can be found, and 
might be obtained, on the river bottom. The plan was discussed of carry- 
ing the sewer along the road from the asylum to Athens, hanging it to the 
bridge which crosses the river, and connecting it with a lateral sewer of 
the Athens system, which passes along the river bank at this point. 

There are several old sewers in Athens which receive considerabb 
house drainage, and which discharge into the Hocking river above the 
dam. One runs from the court house along Main street to the river, 
and another along Vine street. There are perhaps others which we did 
not find. These should be abandoned. 

There ^vas considerable typhoid fever in Athens at the time I was 
there ; and cases of malarial fever were also reported. The health officer 
bowed me ovc-r the village, and called attention to some of the existing 
unsanitary conditions. At his request, upon my return, I sent the follow- 
ing report to the Board of Health : 

Ohio State Board of Health, 
Office of the Secretary, Columbus, Ohio, September 6, 1894. 

To (he Board of Health, Athens, Ohio : 

Gentlemen : The outlet for the proposed system of sewerage for your village 
having been submitted to the State Board of Health, was duly approved. 

In this connection the Board's attention has been called to the fact that a sewer 
from the court house, and several private sewers, are now, and have been, in use for a 
considerable time. We strongly recommend and urge that these sewers be abandoned 
and dug up as soon as connections with the new system can be made. 

Your Board should use every possible means to prevent further pollution of the 
soil by excremental or other filth. In my judgment, this is the prime cause of the prev- 
alence of typhoid fever in the village. While the new sewerage system will remove a 
part of this, you will undoubtedly find that a large number of your citizens will con- 
tinue to use some other means to dispose of their household filth. Privy vaults will 



46 ANNUAL REIV^KT 

still be used for years to come, and unless measures are taken to insure that the contents 
of these vaults will not pollute the soil, the conditions favoring the development of 
typhoid fever and other diseases in your midst will continue to exist. Even should all 
your people abandon their wells and use the public supply lately provided, which is 
not likely to occur for many years, you will not be free from danger so long as soil pollu- 
tion goes on. Water tight vaults, or tight boxes above ground, only should be permitted 
for fecal matter. 

The surface drainage of your town should also be improved. At the present time 
many of your street gutters are choked with grass and weeds, so impeding the flow that 
in many places foul, stagnant pools of water may be seen. The decaying vegetable 
matter in these gutters exposed to the sun, after being overflowed with filthy water, is 
liable to produce malarial fever and other diseases. Without great expense the gutters 
could be laid with split tile, which would afford a smooth surface, easily kept clean and 
free from vegetable growth. 

Our attention was specially directed to the condition of the Hocking river, which 
surrounds a considerable part of the village. A mill dam in the stream causes slack 
water in the greater portion of this part of the river. The sewage from the Athens Hos- 
pital for the Insane, and sewage carried by the court house sewer and private sewers 
referred to above, are discharged into the river above the dam. This has given rise to 
complaints of a nuisance, and it is desirable that this pollution of the river should be 
stopped. 

It has already been advised that the village should cause its private and court house 
sewers to be abandoned, and if possible, sewage from the hospital for insane should be 
kept out of the river above the dam. This matter was laid before the superintendent of 
the hospital. Dr. Dunlap, and he expressed a willingness to use any possible means con- 
sistent with the welfare of the institution, to accomplish this object. Without great 
difficulty the sewage from the hospital could be taken across the river and discharged 
into the village sewers. 

The removal of the dam, which has been advocated, might fail to give the desired 
relief if sewage is still discharged into the river near the village. At the present time 
the Hocking river is a very small stream, and it is questionable whether it would remove 
the sewage of over one thousand people with sufficient rapidity to avert the creation of 
a nuisance in the neighborhood of the sewage discharge. 

I would suggest that the question of disposing of the hospital sewage be brought 
before the trustees of the institution at an early date. The assistance of the State Board 
of Health may be depended upon in arriving at a satisfactory solution of the question. 

Respectfully, 

(Signed) C. O. Probst, Secretary. 

Under date of October 3, Mr. L. E. Chapin, consulting engineer, 
acting witii Mr. Clark in construction of the sewerage system of Athens, 
wrote as follows in regard to this matter : 

"On Friday last Mr. Clark and I made Dr. Dunlap a visit at the asylum, and had a 
long conference on the subject of a purification plant for the sewage and a modification 
of the water supply question for the institution. Dr. Dunlap's position ie this — he 
appreciates that the sewage from the institution discharging into the river above the 
dam is a public nuisance, but he does not think that the Board of Asylum Trustees will 
take any action in the matter to remedy this nuisance untill they are directed or advised 
to do so by the State Board of Health. 

"Now as you know in the construction of the Athens system of sewerage, we are con- 
veying all sewage to an outfall in the Hocking river below the lower dam, and the 
Athens people now consider that it will be no more than equitable on the part of the 



OHIO STATE BOARD OF HEALTH. 47 

•State that the trustees should take measures to prevent the further contamination of the 
waters of the Hocking river by the sewage from a State institution. 

''Further, as engineers, we are personally interested in the matter, inasmuch as the 
State has a number of institutions, the sewage of which must be eventually reduced by 
some method of purification plant in the State of Ohio, and have discussed with Dr. 
Dunlap the matter of submitting a report to the trustees on the water supply and sewer- 
age systems of the irjstitution, and charge them only a nominal sum therefor." 



REPORT ON THE PROPOSED SEWERAGE SYSTEM FOJl 

ASHTABULA. 

Upon request of the council of the village of Ashtabula, the Presi- 
dent, Mr. Hartzell, and the Secretary, on August 25, 1894, went to Ashta- 
bula and inspected the proposed outlet for sewer district No. 2. The 
following report was made to council August 30 : 

To THE Mayor and Cotjncil, Ashtabula, Ohio: 

Deab Sirs : In accordance with the provisions of Section 2 of an act passed March 
14, 1893, the proposed outlet of sewer district No. 2 of your city was submitted to the 
State Board of Health for its approval. 

The undersigned committee, having on the 25th, instant examined the proposed out- 
let, respectfully reports for the Board, as follows : 

The sewer for district No. 2 designed to carry off both storm water and sewage 
proper, will, it is estimated, accommodate about 4,000 people. The proposed outlet is 
into Ashtabula river near Bridge street, which is but a short distance above the river's 
outfall into the lake. At this point, by dredging, the river is kept constantly about 18 
feet in depth. At Mary street, some distance above Bridge street, sewer district No. 1 
has its outfall into Ashtabula river. These sewers will accommodate the greater part of 
the entire population of the city. The river receives in addition the excrement of 
several hundred men employed on vessels or about the harbor. 

In considering the effect the proposed addition of sewage to Ashtabula river will 
have upon the public health, two questions present themselves: (a) the pollution of the 
public water supply ; (b) the creation of a nuisance in and about the harbor. 

The water supply is taken from the shore of Lake Enie without purification, about 
2,000 feet west of the natural mouth of Ashtabula river. By artificial means the real 
outlet of the river is extended into the lake, so that the intake for the water works is 
about 3,000 feet from the point where the river discharges into the lake. As a rule sur- 
face currents in the lake at this point are from west to east, so that impurities in the 
river are usually carried away from the water supplyV It is unquestionably true, how- 
ever, that at times lake currents are in the opposite direction, so that there is a possibil- 
ity of impurities in the river, under favoring conditions, gaining access to the public 
water supply. It may be claimed that this danger has existed for gome time, as sewer 
district No. 1 has discharged into the river for some years, and that no apparent evil 
has resulted from it. We must remember, however, that up to this time but few water- 
closets have been connected with the sewers, and it is pollution of this character that is 
most liable to produce disease. It is reasonable to suppose that the majority of your 
houses will eventually be provided with water closets, and as privy vaults are a menace 
to health, the sooner this is brought about the better, and so there will be an increasing 
excremental pollution of the river and an increasing danger to the public water supply. 



-: ^ ANNUAL REPORT 

Even under present conditions we are deeply apprehensive that a conjunction of favor- 
able conditions will, without warning, produce an outbreak of disease among public 
water consumers. To discharjje the sewage of district No. 2 into the river so near its 
mouth will very greatly increase this danger. Unless, therefore, steps are to be taken to 
charge the source of your water supply by removing the intake to a point beyond danger 
of contamination, or to provide for the continuous purification, by adequate filtration 
areas, of the present supply, we are of the opinion that it would be unwise to discharge 
additional sewage into A-htabula river unless it is first purified. The turning of the 
raw fewage into water courses is always to be deprecated; and in. view of the growing 
sentiment against such pollution, and the possibility of legislation in the near future 
libsolutely prohibiting it, any system of sewerage adopted at this day should contem- 
plate, ultimately, the purification of the sewage. We have two examples in our own 
State — at Canton and Oberlin — showing that sewage can be effectually purified and with- 
out burdensome expense. 

There remains the probability of creating a nuisance by the additional discharge 
of sewage into the river. VVe believe the danger of so doing is not great. The fact 
that the sewage will be discharged into eighteen feet of water which gradually flows 
into the lake ; that this water is frequently agitated by passing boats of deep draught, 
favoring oxydation ; that the channel is dredged once or oftener every year, and 
finally, that the Ashtabula river is subject to freshets, which would tend to remove all 
deposits, favor this view. 

As part of sewer district No. 2 is so low that the river affords the only possible out- 
let for drainage, without pumping, we approve of the proposed outlet of this district, 
subject to the restrictions contained in the foregoing with reference to a change in the 
near future of the source of your public water supply, or else an adequate purification 
of the present one. 

We desire to express our sincere thanks to your mayor, members of council, city 
engineer and health officer, for courtesies which enabled us to conduct the investigation 
under the most favorable circumstances. 

(Signed) E. T. Nelson, 

JOSIAH HaRTZELL, 

C. O. Probst, 

Committee. 



REPORT ON THE PROPOSED SEWERAGE SYSTEM FOR HAMILTON. 

Ohio State Board of Health, 
Office of the Secretary, November 27, 1894. 
To the Commissioners of Seiuers, Hamilton, Ohio : 

Gentlemen : In accordance with the provisions of Section 2 of an act passed 
March 14, 1893, the undersigned committee of the State Board of Health, on November 
22, 1894, inspected the outlets of your proposed system of sewerage, and the same are 
hereby approved. 

The Board desires to state, however, that it considers there is a possibility that sew- 
age from sewer district No. 3 will in time be of sufficient quantity to create a nuisance 
along the river front. This possibility has happily been anticipated by your commis- 
sion, and the grades in this district will permit of the extension of the outlet sewer so 
as to form a junction with the combined outlet sewers for districts 1 and 2, should this 
become necessary. 

The Board is greatly pleased to note that the whole system has been arranged with 
the view of ultimately purifying the sewage before turning it into the river. But for 
this commendable foresight on the part of your commission it would be necessary for 
the Board to withhold its approval. 



OHIO STATE BOARD OF HEALTH. 49 

Your attention is respectfully called to the necessity for regulating connections 
with the public sewers, and the construction of house drains and plumbing. Unless 
such work is done in a safe manner sewers may become an actual menace to the public 
health. It is recommended that your commission formulate an ordinance to be pre- 
sented to council for adoption, which shall designate how all such work shall be done, 
and provide lor an inspector to see that the ordinance is properly enforced. 

The thanks of the committee are due, and are hereby tendered, to the members of 
your commission for the courtesies wliich enabled it to perform its work to the best 
possible advantage. 

Respectfully submitted. 
(Signed) 

Byron Stanton, M. D., 
Thos. C. Hoover, M. D., 
C. O. Probst, M. D., 

Committee. 



EEPORT ON THE PROPOSED SEWERAGE SYSTEM FOR MARIETTA. 

Ohio State Board of Health, 
Office of the Secretary, 3farch 14, 1894. 
Mr. C. M. Willis, Secretary Committee on Sewerage, Marietta, Ohio : 

Dear Sir : The State Board of Health, through its committee on sewage dis- 
posal, has duly considered the plans for sewering the city of Marietta, as exhibited by 
the plans of the engineer, and reports as follows : 

The proposal to discharge sewage into the Muskingum river above the dam is not 
approved, as it is believed such a procedure will eventually create a nuisance. This 
opinion is based on the conditions known to exist in other cities in Ohio where nui- 
sances have been created by the retention of sewage in slack water by a dam. 

This objection may possibly be met by arranging your sewerage system so as to 
conduct all sewage below the dam at some future time. The Board does not recom- 
mend this plan, as it has been found difficult to change the outlet of a sewer, once it is 
established. 

The Board recommends that the system be so arranged that all, or practically all, 
of the sewage can be discharged at one point. This recommendation is made in view 
of the fact that there is great probability that legislative action will be taken in the 
near future to compel corporations to purify their sewage before turning it into streams 
affording public water supplies ; and to purify sewage it is necessary, in practice, to 
collect it at one point. 

The Board further recommends, that in certain portions of" the city where wet cel- 
lars are encountered, additional means should be provided for subsoil drainage ; and 
would emphasize the fact that one of the important functions of a sewerage system is 
the permanent lowering of the ground water, so as to insure dry cellars and foundation 
walls, conditions favorable to health. 

Respectfully submitted for the State Board of Health. 

(Signed) Josiah Hartzell, 

E. T. Nelson, 
C. O. Probst, 

Committee. 

At the request of the Marietta committee on sewerage, the Secretary 
visited Marietta and looked over the ground. The report of the Board's 
committee, after further consideration, was reaffirmed. 

4 ST. B, H. 



50 ANNUAL REPORT 

At a meeting of the State Board of Health held October 26, 1894, Mr. 
L. E. Chapin, consulting engineer, presented modified plans for the sew- 
erage of Marietta. 

"On motion of Dr. Hoover, duly seconded, it was voted to approve 
the plans for the sewerage of the city of Marietta, as submitted by INIr. L. 
E. Chapin, consulting engineer, subject to the following change, i. e., 
that the outlet for sewer district No. 1, should be merged into the outlet 
sewer for sewer district No. 2, said outlet to be located at the foot of Post 
street." 



REPORT ON THE PROPOSED SEWERAGE FOR MARYSVILLE. 

BY THE SECRETARY. 

October 8, the mayor and a member of the board of health of Marys- 
ville called at the office and invited me to visit that village. The local 
board, they stated, was endeavoring to secure the introduction of sewer- 
age, and desired the support of the State Board. 

I went to Marysville October 10, and met the full board of health. 
The situation there is as follows : A public water supply was introduced 
some years ago. This induced a great many persons to place water 
closets and baths in their houses. There are several short lines of sewers 
ior storm water, but only a few houses have been connected with them. 
Flowing through the central part of the village is a run, which affords a 
natural outlet for surface drainage. In addition, it receives a considerable 
amount of house drainage, a number of private drains opening into it. 
Many privies and stables also drain into it. As a result, this run has be- 
come exceedingly foul and offensive. The only plan for effectually abat- 
ing the nuisance thus caused is sewerage, and the board of health was 
circulating a petition among the citizens, praying council to submit the 
question of sewerage to a vote of the people. The members of the board 
were of the opinion that the majority would be in favor of sewers. They 
wished to have the State Board of Health support their petition to 
council, which was to be presented on the day following my visit. 

At the request of the board I made them a report as follows : 

Ohio State Board of Health, 
Office of the Secretary, Columbus, O., October 11, 1894. 
To the Board of Health, Marysville, Ohio : 

Dear Sirs: On the lOth instant, at your request, I examined into the sanitary 
condition of your village, with special j-e<'erence to its needs as to sewerage. 

The most objectionable feature of your village, from a sanitary standpoint, is the 
jrun which passes through it. The run is alieady polluted to a degree that renders it a 



OHIO STATE BOARD OF HEALTH. 5 1 

nuisance, detrimental to the health and comfort of many of your citizens. The condi- 
tion will undoubtedly grow worse from year to year, unless measures are taken to pre- 
vent it. This run is admirably adapted to remove surface drainage ; and if it were 
kept open, and everything but storm water kept out of it, the run would be unobjec- 
tionable. 

The easiest way to deal with the run will be to provide a system of sewerage to 
carry off the filthy drainage which it now receives. As you have introduced a public 
water supply, sewerage has become a matter of necessity, for a public water supply 
always means a greatly increased amount of filthy water to deal with. 

Sewerage will be a benefit to your village in other ways than the getting rid of the 
nuisance connected with the run. The prevalence of typhoid fever, consumption, 
diarrhceal and other diseases, is almost invariably lessened by the introduction of a 
proper system of sewerage. 

Your board should, therefore, urge upon council and upon your citizens, the necessity 
of sewers. You should also condemn the run as a nuisance ; and if sewerage is not 
provided, should take steps to lessen the nuisance, as much as possible, in some other 
manner. 

Trusting you will be able to secure for your village this greatly needed improve- 
ment, I have the honor to be, 

Very respectfully, 

(Signed) 0. O. Probst, Secretary. 



REPORT ON SEWAGE DISPOSAL AT OBERLIN. 

BY THE SECRETARY. 

During the winter of 1893-4 complaints were made to this Board 
that the sewage of Oberlin was polluting Plum creek, creating a nui- 
sance and spoiling its waters for stock purposes, so that the dairy products 
of cattle using the water were unsalable in Oberlin. Your Secretary 
was appointed a committee to investigate the complaint, and, if the facts 
should prove to be as represented, to bring the matter to the attention of 
the Oberlin authorities, and endeavor to have them abate the nuisance. 

By corresponding with the city engineer of Oberlin, and with the 
health authorities, it was learned that the sewage of Oberlin was being 
turned into Plum creek, but from the beginning, in introducing the sew- 
erage system, it had been recognized by the sewer commissioners and city 
engineer that it would be necessary to purify the sewage before discharg- 
ing it into Plum creek. Land adjacent to the village had been pur- 
chased for that purpose, and the commission was considering what plan 
of sewage disposal would be best suited to local conditions. Later I was 
informed that experiments were being made in sewage disposal by inter- 
mittent filtration. 

On June 20, having been called to that part of the State on other 
business, I visited Oberlin and spent the day studying their plans of sew^ 



5-' 



ANNUAL REPORT 



erage and sewage disposal. Prof. Talbot, of the University of Illinois^ 
happened, fortunately, to come to Oberlin on the same day, and for the 
same purpose. 

I am greatly indebted to Mr. W, B. Gerrish, city engineer, and to 
Prof. A. A. Wright, member of the board of sewer commissioners, for 
many courtesies extended to me while there, enabling me to use the time 
at my disposal to the best possible advantage. 

I would first briefly note the essential points concerning Oberlin's 
sewerage system. The system was built in 1893 and placed in operation 
the latter part of that year. It consists of a trunk sewer of which 1,360 
feet are of 8-inch pipe, 790 feet of 10 inch pipe, and 8,650 feet of 18-inch pipe. 
The district sewers consist of 25,000 feet of 6-inch pipe and 55,000 feet of 
8-inch pipe. There are twenty-three Rhodes- Williams flush tanks in the 
system, and a subsoil pipe of agricultural tile is laid at the side of all dis- 
trict sewers, with which all cellar connections are made. Ventilation is 
secured by manholes with open covers, and by open house drains and 
soil pipes. The system is built strictly on the separate plan. All plumb- 
ing and drain laying must be done by persons licensed by the board of 
health. Traps on the house drain are not permitted. The system at 
present will provide for the sewage of about one-half the population. The 
cost of the sewerage system was about $20,000. 

For the disposal of the sewage the city purchased fifteen acres of 
ground one-half mile from the corporate limits, at a cost of $1,500. This 
field is bounded on the north by a road leading to Oberlin. Running 
eastward through the field, near its middle, is Plum creek. The land 
between the creek and the road mentioned is much higher than the out- 



^tM Amot 9Beas-2gAins. 
Underdrawedbjf^and^in.AL 
ltc4fccieg). La/dZOffCto, 




Oberlin Sewerage Plant. 



OHIO STATE BOARD OF HEALTH. 53 

fall sewer, and will not be used for disposal purposes. It has been plenti- 
fully planted with trees and will be converted into a park. A considerable 
portion of the land south of the creek is also above sewer level, leaving 
about six acres available for filtration or irrigation. Two and a half acres 
of this available ground have been prepared for intermittent filtration by 
grading gently towards the creek, and by underdraining with agricultural 
tile of two and a half to four inches laid at a depth of three to four feet, and 
twenty feet apart. The two and a half acres are subdivided into nine areas 
of about equal size by means of ridges of earth a foot high. To the east of 
the filter beds separated from them by a drive way, two and three-quar- 
ters acres have been set apart for broad irrigation. This area has not been 
prepared by grading or by tiling, except a few hundred feet of tiling for 
draining some low places. It is sowed in grass. Of the nine filtering 
areas three are seeded to Italian rye grass, three to alfalfa, and three are 
planted with corn and other garden vegetables. The outfall sewer termin- 
ates south of the filter beds, and at a higher level. Near its terminus, at 
a manhole, a short branch sewer joins the main sewer, giving two outlets. 
Settling basins, which are merely pits in the ground twenty-five feet long, 
four feetwide, and three feet deep, are at the ends of the outlets. A board at 
the top and near the middle of each basin, dips a few inches into the sewage 
and keeps back floating matter. Ditches made by running a furrow with a 
plow and trimming up the edges, serY© to convey the sewage from the 
settling basins to the filtering beds, or to the irrigation field, as may be 
desired. Simple mud dams in the ditch stop the sewage wherever desired 
and cause it to overflow the surface selected for filtration or irrigation. 
The effluent from the filter beds is carried by the drain tile to Plum 
creek. The settling basins require emptying once a week. A portable 
tank fitted with a pump with a 4-inch suction, is used for this purpose. 
Considerable odor is caused by the emptying of the basins, though this 
is probably not carried as far as the highway or to the farm houses nearest 
the field. At least no complaint of this was heard. The sludge is either 
spread over the grass on the hillside south of the disposal works, or is 
plowed under. Bad odors, it is claimed, quickly disappear after spread- 
ing the sludge on the grass. It was interesting to note the remarkably 
luxuriant growth wherever the sludge was thinly spread. One could 
stand at any part of the field and mark where the sludge wagon had been 
by the deep green color and thick growth of the grass. Where the sludge 
was dumped in a mass the grass was killed. So on the field flooded 
with sewage — its track was plainly marked by the appearance of the 
grass, showing, also, that the field had not been evenly flooded. This 
difficulty, i. e., uneven flow of the sewage, had been met with in flooding 
the filtering areas, for there was a tendency for the sewage to collect in 



54 ANJSUAL REPORT 

little channels. Occasionally it will work holes down to the underdrains 
and unpurified sewage then escapes into the creek. It is expected that 
this tendency to concentration of sewage flow will have been removed 
when the rye grass and alfalfa attain some growth. This difficulty seems 
to have been overcome at Freehold, N. J., according to the report of Geo. 
E. Waring, Jr., as published in the 13th annual report of the State 
Board of Health of New Jersey. At these works a line of broken stone is 
laid a short distance from and parallel to the carrier ditches, so that the 
overflowing sewage is caught and spread out on its way over the filtering 
area. I have called the attention of the Oberlin engineer to this plan and 
have suggested that he should try it on one area. 

At the present time — June, 1894, the daily sewage flow varies from 
35,000 to 45,000 gallons. The present filtering area, it is calculated, will 
dispose of 80,000 gallons per day. 

The point of greatest interest in connection with this sewage farm, 
excepting only its ability to properly care for the sewage, is the remark- 
ably low cost at which it was constructed. Those having the matter in 
charge are to be congratulated on having apparently placed the disposal 
of sewage, so far as the expense is concerned, within the reach of every 
sewered village in the State. Local conditions, it is true, determine to a 
large extent the expense ; but th^simplicity of the whole system at Ober- 
lin must commend it to all economists. 

The expense of the sewage farm at Oberlin was as follows : 

6,000 feet of agricultural tile laid $256 00 

Tool house 55 00 

Grading and incidentals 166 00 

Pump and tank 42 00 

Twenty acres of land 1,500 00 

Total $2,019 00 

The soil is not specially favorable for sewage disposal. About Oberlin 
the soil generally consists of yellow clay underlaid at a few feet with stiff, 
blue clay, and it was feared that sewage filtration would be impracticable. 
It was found, however, that that part of the field next the creek contained 
considerable sand mixed with the clay, while in the upper part of the field 
numerous strata of gravel were found. The land drains freely and there 
has been no trouble from retention of water. 

The farm is free from nuisance. Slight sewage odor is noticeable in 
walking along carrier ditches or over ground with sewage on it, but this 
is not discoverable a short distance away. There was no odor from the 
Btream into which the sewage effluent is discharged, at least none from 



OHIO STATE BOARD OF HEALTH, 55 

the part of the stream examined, embracing its flow through the farm 
and several hundred yards below. 

Plum creek flows through the village of Oberlin and, about six miles 
below the sewage farm, joins Black river. Two miles from this junction 
the city of Elyria takes its water supply from Black river. I was informed 
by the health ofiicer of Elyria, Dr. McLean, that the public water supply 
is used only for fire protection and sprinkling ; wells being entirely relied 
upon for potable water. In dry weather Plum creek has little or no flow. 
or would have but for the overflow from the water works. The water 
supply of Oberlin is obtained from Vermillion river about six miles from 
the village, and is delivered by gravity to the pumping station. There is 
considerable overflow into Plum creek, and this, together with the sewage 
effluent, keeps up a constant flow. 

There is some drainage into this creek within corporate limits, but 
this will be stopped. 

In this connection is worthy of note a plan adopted by the city 
engineer for improving this creek within the village— a plan which I 
should like to see adopted in other places where small streams flowin^^ 
through villages present an unsightly appearance, and tend to create a 
nuisance. An 8-inch drain has been laid through a part of Plum creek 
and the creek banks and drain covered over with sod. In some places the 
drain is covered with broken stone. The effect is to greatly beautify the 
landscape; and I should judge that the value of property along the stream 
would be sufficiently enhanced to cover the cost of the improvement. 
The ordinary flow is easily cared for by the 8-inch drain. Flood water 
will pass through the sodded run. 

I called on Mr. Carrothers, who lives on a farm just north of the 
sewage farm. He was one of those who complained to this Board of the 
pollution of Plum creek. His attitude toward the sewage farm was one 
of hopeful expectation. He said the nuisance of which he complained 
seemed for the present, to have been removed, and he trusted they would 
have no further trouble. The objection formerly urged against his butter 
and milk, on account of watering his cows at Plum creek, had been with- 
drawn. So far as he knew other farmers living along the stream were not 
now complaining of sewage being turned into it. Mr. Hamilton owns a 
farm just east of Mr. Carrothers, which he rents. He accompanied us on 
one of our trips to the sewage farm. He stated that he had lost an oppor- 
tunity for selling his farm on account of the proximity of the sewage farm. 
This was due entirely to prejudice which will doubtless be removed in 
time. 

Four samples of water were collected and submitted to Professor 
Howard for examination. One from Plum creek just above the sewage 



56 



ANNUAL REPORT 



farm, one from the creek a few hundred feet below, and one of sewage 
just before it entered the settling basin or pit, and one from the tile drain 
underlying a filtering area which had been flooded during the morning. 
The first two samples were collected about 11 a. m., the last two about 
4 p. M. 

The results of examination were reported by Prof. Howard as follows : 

Columbus, O., July 13, 1894. 
Dr. C. O. Probst, Secretary of State Board of Health : 

DsAK Sir : I have examined the samples of water received from Oberlin, with the 
following results : 



Collection June 20. 

1. Plum creek above filter bed. 

2. Sewage. 

3. Effluent. 

4. Plum creek below filter bed. 



Collection July 2. 

5. Plum creek above filter bed. 

6. Sewage. 

7. Effluent. 

8. Plum creek below filter bed. 



Parts per 100,000. 





Oxygen 


Free 


Albuminoid 


Nitrous 


Chlorine. 


Total 


Mineral 


Organic & 




required. 


ammonia 


ammonia. 


acid. 


solids. 


matter. 


volatile 


1. 


1.02 


.026 


.034 


.001 


3.52 


51.6 


34.8 


16.8 


2. 


7.92 


1.320 


.680 


none 


8.64 


112.8 


62.4 


50.4 


3. 


216 


.180 


.090 


.005 


4.44 


71.6 


50.2 


21.4 


4. 


1.31 


.058 


.064 


.010 


3.56 


57.4 


38.2 


19.2 


5. 


.96 


.012 


.024 


.001 


1.52 


36.4 


. 25.6 


10.8 


6. 


3.60 


.920 


.320 


none 


5.00 


85.2 


54.2 


31.0 


7. 


1.84 


.090 


.048 


.010 


3.00 


59.6 


43.4 


16.2 


8. 


1.21 


.036 


.038 


.015 


2.16 


42.4 


30.0 


12.4 



These two series of results are interesting as indicating the variations resulting from 
certain changes in conditions. While it is a matter of information with you, it may be 
well to note here that the first set of samples were taken during commencement week, 
when Oberliii contained a somewhat larger population than at the second date. This is 
well shown in those determinations of organic matters, or of substances accompanying 
organic matter. This will not of course explain the reduction in the total solids in the 
creek, but I am informed by Mr. Gerrish that on the Thursday night preceding the col- 
lection of the last samples, there was a heavy shower. To this, in part, is to be ascribed 
the reduction in the organic constituents shown. It will be noted that there is a con- 
siderable reduction in the chlorine in the effluent as compared with the sewage. This is 
a constituent of common salt, and is a measure of that substance. This is a result which 
I had not anticipated, but duplicate determinations confirm the certainty of this result. 
The examination shows that the water of Plum creek above the filter bed is of very 
poor quality ; that a very large proportion of the organic constituents of sewage is 
deposited in the filter beds, as is shown by the greatly improved quality of the effluent ; 
and that after this had been introduced into the creek, while the deterioration of the 
water of the creek is shown, it is not a series contamination of the water of that stream. 
Kespectfully submitted. 

(Signed) Curtis 0. Howard. 



OHIO STATE BOARD OF HEALTH. 57 

Analyses of the sewage and effluent were made May 14, 1894, with 
the following results as taken from a report published by the city engineer. 

Parts per 100,000. 



Sewage 
Effluent 



If Oberlin's attempt to purify her sewage should prove to be success- 
ful, as it bids fair to be, we will have within our own State, including 
Canton's sewage works, examples showing that it is practicable and with- 
out burdensome expense, to purify all sewage turned into our lakes and 
streams. 



Free 


Albuminoid 


Total 


Oxygen 


ammonia. 


ammonia. 


solids. 


oonsnmed. 


2.6256 


1.6080 


4.2336 


11.135 


t 0.0918 


0.0343 


0.1261 


0.510 


it. removed 96 


98 


97 


95 



EEPORT ON SEWERAGE FOR WARREN. 

Ohio State Board of Health, 
Office of Secretart, Columbus, O., March 15, 1894. 

'Mr. R. W. Paden, Chairman Server Committee of Council, Warren, Ohio.: 

Dear Sir : In compliance with your request, a duly appointed committee of the 
State Board of Health, consisting of Prof. E. T. Nelson, President, Dr. C. O. Probst, Sec- 
retary, and Josiah Hartzell, visited Warren on March 9. 

To the committee was extended every facility for acquiring a good understanding of the 
sanitary features of your proposed sewers; by conference with the members of your com- 
mittee, with members of your board of health, and other citizens; by examination and 
explanation of your maps by your city engineer, and by a personal inspection of proposed 
routes and outlets of sewers. We take this opportunity of extending to you, and to the 
other citizens of Warren who gave needed assistance, our sincere thanks for courtesies 
received. 

We feel constrained, before proceeding further, to express our approval, and even our 
udmiration, of the thorough, systematic and intelligent methods which characterize the 
work of those entrusted with the care of Warren's sanitary interests. The plans in oper- 
ation, in non-sewered districts, for regulating the storage of excreta, and your disposal 
of the same, are features worthy of wide adoption. It would be difficult to conceive of a 
more convincing indication of popular enlightenment than your well sustained effort in 
the attempt to reach so high a grade of excellence in these, and other matters which 
came to our knowledge. 

It is, however, true that in respect to quality of water supply and the disposal of 
sewage-, both present and proposed, there is, in Warren, much room for improvement. 
We were informed that measures looking toward greater purity of the water were in con- 
templation. 

In regard to the sewers we beg to report the result of our observations as follows: 

The general course of the Mahoning river through the city is from north to south. 
Near the north line of the city is a dam, at Summit street. In the south-central part is 
the dam at Market street. The water pocket formed by the last named dam is skirted 
by the most important and thickly populated part of the city. 



58 



ANNUAL REPORT 



It is to be regretted that the flow of running water in that part of the river's channel' 
being within the city could not be unobstructed. The contiguity of a running stream^ 
uncontaminated by sewage, would be unobjectionable. The contrary is true of ponds, 
especially of stagnant waters not derived directly from springs, but consisting rather of 
the drainage of the watersheds of the upper stream. 

In Warren we find such a body of water, which, in dry seasons, must necessarily be- 
come very objectionable. In the bottom of this dam is stored the debris and scourings 
of streets and roads for many years. The most objectionable tributary to this dam is 
the outlet of the Market street sewer. 

We do not feel called upon to dwell upon this feature. A public which evinces such 
an intelligent appreciation of approved sanitary methods must comprise in its body those 
who are entirely capable of giving all merited criticisms. These are not therefore required 
of us, and it is besides always most desirable that the cure for such evils proceed from, 
within rather than without. 

It was not surprising to find those who desired the retention of the dam because the 
presence of the water body is pleasing to the eye. The [lark effect of the river, and its 
banks, is not a feature to be despised. The lagoons designed by Frederick Law Olmsted 
constituted a capital attraction at the late World's Fair. They were deepest at the two 
ends and the constant current maintained in them assured a purity equal to that in 
Lake Michigan. In the pond at the 57th street entrance, the prettiest on the grounds, 
only a feeble surface flow could be kept up. Mr. Olmsted has recommended, and the 
park commissioners have ordered, the latter to be filled up. 

The situation warrants these suggestions : 

1st. Divert all the sewage tributary to the Market street sewer into the Pine street 
sewer, reserving the former for storm water exclusively. 

2d. Assuming that the lower dam is to remain, build an exit low enough to permit 
the occasional outflow of all accumulations. 

3d. Let all sewer routes converge to one point of outflow below the city. 

Having in view O. L. Vol. 90, March 14, 1893, we will say that no sewer plan con- 
templating the delivery of crude sewage into any part of the dam can be approved by 
this Board. 

The relations sustained by the water in the upper dam to the welfare of the city 
easily suggest inquiries that may arise, and difficulties that may present themselves, on 
the part of those having riparian interests below the city. 

This is not the place for a discussion of the subj-ct of stream pollution. But it is 
entirely pertinent to advise : 

1st. That in building sewers the separate system be strictly adhered to— no rain or 
storm water admitted. 

2d. That the outfall of all sewers be at, or near, the same point, and 

8d. That the subject of sewage treatment, with a view to obviating the pollution 
of the Mahoning river by delivery therein of the wastes of your city, engage your early 
and earnest attention. 

Eespectfully submitted. 
(Signed) Josiah Hartzell, 

E. T. Nelson, 
C. O. Probst, 

Committee. 



OHIO STATE BOARD OF HEALTH. 59 

REPORT ON A PROPOSED ADDITIONAL WATER SUPPLY 
FOR BOWLING GREEN. 

BY THE SECRETARY. 

The board of health of Bowling Green reported that the water works 
company of that village was about to introduce additional supplies, taken 
from an old quarry in the central part of the town, and it was feared that 
the water was unfit for use. I was requested to come there and make an 
examination of the proposed supply, which I did on August 27. 

Water works were introduced into Bowling Green a year ago, the 
supply being obtained from bored wells situated at the edge of the village. 
The works are owned and operated by a foreign company. There has 
been no question as to quality of water, and none as to quantity until 
during the drought of the past summer. The wells then began to fail, 
and it was necessary to stop the use of water for sprinkling. This raised 
quite a cry from those whose lawns were suffering for water, and the 
company, in seeking for additional supplies, proposed to make use of a 
well which some years before had been drilled near a stone quarry. The 
well was not used after boring and the quarry was extended until it took 
in the well. 

This quarry is an immense hole, fifteen or eighteen feet deep, and 
was about half full of water. The board of health at first understood that 
it was the water standing in the quarry that the company proposed to 
use, and sent a sample of it to us for examination. When it was learned 
that they proposed to use water from the well there were still many who 
feared this water was polluted and unfit for drinking. 

The company fitted up an engine and pumps and emptied the quarry. 
Considerable filth was found in the bottom, which was treated with lime. 
It was reported that formerly, when this quarry had been emptied of 
water, the wells in the neighborhood were exhausted. This was not the 
case on this occasion. 

The well from which it was proposed to pump is 180 feet deep, being 
fourteen inches in diameter for the first eighty feet, and eight inches for 
100 feet. 

I met the health officer and members of the board, and the super- 
intendent and one or two officials of the water works company, and 
obtained as much information as possible. I am also indebted to Mr. 
Evers, a member of council, who showed me about the village and gave 
me considerable information. 

In the evening, by invitation, I addressed the council on the subject 
of sewage disposal. Sewerage is greatly needed by Bowling Green, but 
the disposal of it will be a difficult problem. 



6o ANNUAL REPORT 

The water works company agreed to furnish a sample of water from 
the well in the quarry after it had been pumped for twenty-four hours. 
The sample was to be collected in the presence of representatives of the 
board of health and of the water works company. Inasmuch as there 
was a strong feeling on the part of many citizens, including several of the 
physicians, that this water should not be used, I deemed it wise to have 
my opinion in the matter supported by that of the President. At my 
request, he went to Bowling Green on September 3, and made an 
independent investigation. 

The following report was received from Professor Howard : 

Columbus, O., October 8, 1894. 

Dr. C. O. Probst, Secretary Ohio State Board of Health, City : 

Deab Sik: I have examined the two samples of water received from Bowling 
Green, with the following results : 

No. 1. Sample received August 22, water from stone quarry. 
No. 2. Sample received September 1, water from well in quarry. 







Parts 


per 100,000. 








Oxygen 


Free 


Albuminoid 


Nitrous 


Xitric 




Total 


required. 


ammonia. 


ammonia. 


acid. 


acid. 


Chlorine. 


solids. 


1. .97 


.009 


.030 


.001 


.035 


2.48 


49.2 


2. .16 


.008 


.006 


.002 


.015 


1.24 


48.6 



In No. 1 the oxygen required and albuminoid ammonia are so high that an un- 
favorable opinion would have to be formed of the water. The general character of the 
figures indicates that the water is suffering from a recent contamination rather than from 
one of long standing. 

In No. 2 the free ammonia is higher than could be desired, but all the other con- 
stituents are so satisfactory that the. sample could hardly be condemned for this alone; 
with this exception the water is quite satisfactory in character as indicated by these 

figures. 

Yours truly, 

Curtis C. Howard. 

The President called at the office September 4, and after hearing the 
report from Professor Howard, joined in the following report to the water 
works company of Bowling Green, a copy of which was sent to the board 
of health : . ' 

Ohio State Board of Health, 
Office of the Secretary, Columbus, O., September 6, 1894. 

To the Bowling Green Water Co , Bowling Green, Ohio : 

Dear Sirs: After having investigated the proposed additional water supply for 
Bowling Green, to be obtained from the well located in what is known as Eoyce quarry, 
we respectfully report that in our judgment the water from this well may be used with- 
out endangering the public health. 

A chemical analysis of water taken from the well after twenty-four hours' continu- 
OTiB pumping, indicates that it is free from pollution. Sample of the water taken from 
the quarry, before it was emptied by pumping, was also submitted to chemical examina- 



OHIO STATE BOARD OF HEALTH. ^6l 

tion. This showed that the water in the well is of a different quality from that in the 
quarry, and that the well does not receive water from the quarry. 

The upper part of the well must be tightly cased to prevent surface water getting 
into it, and the quarry must be kept free from water. With these conditions fulfilled 
the use of the well for additional water supplies is temporarily approved. 

(Signed) C. O. Probst, 

E. T. Nelson, 

Committee. 

APPKOVAL OF WATER SUPPLY FOE GALLIPOLIS. 

December 19, 1894. 
Mr. Hollis C. Johnston, Acting Secretary of Water Works Trustees, Gallipolis, 0.: 

Dear Sir : The proposed source of water supply for the city of Gallipolis having 
been duly examined, as required by Section two of an act amending the act to create and 
establish a State board of health, the same is hereby approved. 

Respectfully, 
(Signed) B. Stanton, 

Thos. C. Hoover, 
C. O. Probst, 

Committee. 



INVESTIGATION OF A PROPOSED EXTENSION OF THE 
WATER SUPPLY OF LANCASTER. 

BY THE SECRETARY. 

My attention having been called to the fact that the city of Lancaster 
was about to extend its public water supply, I notified the water works 
trustees that it was necessary to secure the approval of this Board. 

After some delay the secretary of the water works board made a 
formal request for such approval. I was appointed by the President to 
go to Lancaster and make the necessary examination, which I did on the 
loth of September. 

Lancaster's water works were built in 1880, and are owned and 
operated by the city. The present daily capacity is about 1,200,000 gal- 
lons. Water is obtained from a filtering gallery about 700 feet long, con- 
nected with a well from which the water is pumped to a stand pipe with 
a capacity of 133,000 gallons. The gallery has brick side walls and 
arched top, cemented, and w four feet wide and four and one-half feet 
high. The well is eighteen feet in diameter and twenty feet deep. 

The gaUery is located on a river bottom, between the Hocking canal 
and Hocking river. The distance from the gallery to the river is from two 
to three hundred yards. The bottom of the canal is considerably higher than 
the surface above the gallery. The ground beyond the canal towards the 
town rises to a hill 250 feet or more higher than the canal. Several inde- 



62 ANNUAL REPORT 

pendent sewers run down this hill, pass under the canal and over the 
filtering gallery, and discharge onto the river bottom beyond. A slight 
rise in the surface towards the river serves to retain most of this sewage 
on the bottom. The geological formation of this hillside and bottom has 
probably protected the water supply from pollution. On the high 
ground there is a deep deposit of sand and gravel underlaid by a thick 
deposit of clay. In this part of the city wells obtain their water from the 
ground water above the clay. This clay layer seems to extend down the 
hill, under the canal, but over the filtering gallery and onto and possibly 
under the river. 

This gives a complete protective cover to the public water supply, 
which is obtained from a deposit of sand and gravel under the clay. 
This cover, it is true, was pierced when the filtering gallery was con- 
structed, but great care was taken to replace the cover. 

The gallery, has furnished a continuous and unfailing supply. Even 
this year, with its almost unprecedented drought, there has been little or 
no diminution of the supply, and it is only on account of the increased 
demand for water that an addition to the supply is proposed. 

I called on the health officer, Dr. Hershberger, and three or four of the 
old physicians of Lancaster, and questioned them in regard to any sick- 
ness ever having been traceable to the public water supply. All were of 
the opinion that such had never been the case. 

I met the board of water works trustees and went with them over the 
ground of the proposed new filtering gallery. At the upper end of the 
proposed gallery, by an old mill, there is a spring, and it was proposed to 
include this in the new water supply. This spring breaks out at the foot 
of the hill referred to, and is above the protective clay layer. 

The abominable practice exists in Lancaster of using abandoned 
wells for cess-pools. Many of the houses are provided with bath and 
water closets without sewer connection, and a frequent expedient in 
getting rid of such waste is to run it into an old well or uncemented cess- 
pool. The soil is so porous that the liquid readily drains away, and such 
places rarely need emptying. Wells are still used by nearly one-half the 
people. 

In spite of these conditions there does not seem to have been an 
unusual prevalence of typhoid fever or other water borne diseases. This, 
I think, is attributable to the excellent filtering qualities of the soil. 
None can predict how much longer the inhabitants of Lancaster will 
escape punishment for this flagrant violation of sanitary requirements. 



OHIO STATE BOARD OF HEALTH, 63 

Three samples of water from Lancaster were examined by Prof. 
Howard, who made the following report September 4 : 

A. Bauman, Esq., Lancaster, Ohio: 

Dear Sir: I have examined the three samples of water received from you, with 
the following results : 



Oxygen 
required. 


Free 
ammonia. 


Albuminoid 
ammonia. 


Nitrous 
acid. 


Nitric 
acid. 


Chlorine. 


Total 
solids. 


1. .20 

2. .09 

3. .12 


.388 
.006 
.008 


.009 
.008 
.007 


.003 

trace 

.001 


.214 
.154 

.724 


1.92 
2.60 
6.66 


65.8 
52.4 
86.4 



These figures express parts per 100,000 of the various constituents named. In 
making an interpretation of these figures it would be well if I knew the sources of the 
various samples, but unfortunately you do not state which is which in your letter, only 
that one is the public water supply and the two others from two wells. However, 
without having this information, I will make the following statements : 

The very large quantity of free ammonia in one suggests contamination with some 
decaying organic matter. The other constituents are not so large but that if this water 
were from a well 100 or more feet in depth, this opinion would have to be modified. 
This illustrates one of the difiiculties in my not knowing more of the nature of the 
source of these samples. I should imagine that two and three are from wells from the 
character of the results. If so, they are waters of fair quality. I leave tomorrow for a 
ten days' absence, but if you will send me a full description of the source of these 
samples I will be able to make a fuller statement as to their quality. I would like to 
see the results obtained from Chicago. I subsequently learned that the sources of the 
samples were as follows : 

No. 1 from the G. E. Harman well. 

No. 2 from the city water works well. 

No. 3 from the J. V. Kinney well. 

A second sample of the public supply, collected by the health ofl&cer, 
was examined by Prof. Howard, who reported October 8 as follows : 

Dr. C. O. Probst, Secretary Ohio State Board of Health, City: 

Dear Sir : I have made a chemical examination of the sample of water received 
from Lancaster, with the following results : 

Parts per 100,000. 
Albuminoid Nitrous Nitric 

ammonia. acid. acid. 

.007 .001 .108 

These figures indicate that this sample of water is of better quality than samples 
two and three of waters reported September 4, and of decidedly better character than 
sample one, reported that date. This is especially evident in the free ammonia, nitric 
acid, chlorine and total solids. These figures, taken in connection with the statement of 
the sanitary survey of the source of the water, lead me to believe that this water is of a 
quality to make it suitable for drinking purposes. 

Respectfully submitted. 
(Signed) CtJRTis C. Howar., 

On receiving this report I made the following report to the water 
works trustees : 



Oxygen 


Free 


required. 


ammonia, 


.10 


.003 



Chlorine. 


Total 
solids. 


1.84 


44.5 



64 ANNUAL REPORT 

Ohio State Board of Health, 
Office op the Secretary, Columbus, O., October 9, 1894. 
To the Board of Trustees Lancaster Water Works, Lancaster, Ohio : 

Gentlemen: In compliance with your requ^t, and with the provisions of section 
2, of an act amending the act establishing the State Board of Health, I visited your city 
on September 15, 1894, and inspected the source of the water supply proposed as an ad- 
dition to your present supply. 

The same is hereby approved subject to the following conditions : 

(1.) The spring near the old mill, at the upper end of the proposed filtering gal- 
lery, is not approved as a part of the new supply. 

(2.) The sewage which is now discharged onto the river bottom near your filtering 
gallery must be diverted to some distant point. 

(3.) The clay cover which protects the source of your water supply and which will 
be cut through in extending the filtering gallery, must be replaced with proper care. As 
a complete sewerage system, which will provide for the needs of your entire city, is ur- 
gently demanded, and, it is hoped will soon be built, it is suggested that in making the 
changes in sewerage above noted to guard against pollution of the water supply, atten- 
tion shall be given to making the new sewer, which will be necessary, a part of the gen- 
eral system eventually to be constructed. 

I enclose herewith a copy of the chemist's report on a sample of water representing 
your present supply, collected by your health officer, Dr. Hershberger, on September 25, 
1894. You may reasonably expect that the new supply will be of the same character. 

KespectfuUy, 

C. O. Probst, M. D., Secretary. 



REPORT ON ADDITIONAL WATER SUPPLY FOR LIMA. 

Mr. President and Gentlemen : Your committee visited the wells 
drilled by the Lima trustees for an additional water supply, on August 
16, 1894. These wells are situated on a tract of land containing forty-five 
acres, owned by the city and are about one mile from the pump station that 
delivers the water into the city mains. The nearest building is a farm 
house about 600 feet from the wells. No other buildings are near. 

The wells, five in number, are situated within a radius of seventy-five 
feet, and are so connected that a single pump delivers the water at the in- 
take of the upper or receiving reservoir. 

Well No. 1 is 118 feet deep. 

Well No. 2 is 150 feet deep. 

Well No. 3 is 133 feet deep. 

Well No. 4 is 180 feet deep. 

Well No. 5 is 140 feet deep. 

These wells are drilled through eighteen inches of clay, eight feet of 
quick-sand, four inches otf blue clay, and about six feet of gravel, when 
the rock lime-stone is struck at a depth of sixteen feet. The balance of 
the depth is in lime-stone. 



Nitric 




Total 


acid. 


Chlorine. 


solids. 


.250 


1.40 


112.8 



OHIO STATE BOARD OF HEALTH. 65 

The capacity of these wells is 750,000 gallons per day. It is estimated 
by the trustees that eight wells would supply the city, the consumption 
of which is 1,000,000 gallons per day. 

The following is the sanitary analysis of this water by Professor 
Howard : 

Columbus, C, October 8, 1894. 

De. C. 0. Pkobst, Secretary Ohio State Board of Health, City : 

Dear Sik : I have examined the sample of water received from Lima, with the 
following results : 

Par/s^Jer 100,000. 

Oxygen Free Albuminoid Nitrous 

required. ammonia. ammonia. acid. 

.20 .030 .010 .001 

The free ammonia in this water is so high that it would nearly condemn the water 
were it not that the other constituents are so low that, taken in connection with the fact 
that the wells range in depth from 118 to 180 feet, I am inclined to regard this as due to 
the reduction of nitrates, and that consequently, no unfavorable opinion can be drawu 
from the high free ammonia. For some reason the oxygen required is some higher than 
will be found in a deep well water of best quality, also the albuminoid ammonia might 
be expected to be a little lower if the water were of the highest degree of purity. Doubt- 
less the chlorine (as common salt), accompanies the mineral constituents of the water 
and does not suggest contamination. No unfavorable opinion can be drawn from the 
quantities of nitrous and nitric acids present. The large quantity of solids (67.6 grains 
per gallon), show that the water is quite hard, as is so frequently found in deep well 
waters. While it would be better if the water were softer, and while the sample does not 
appear to be of the highest degree of purity, yet the water may be regarded as satisfac- 
tory for potable use. 

Yours truly, 

(Signed) Curtis C. Howard. 

The water from these wells, though quite hard, is an improvement on 
the present supply, loaded as it is with organic matter. The city is indeed 
fortunate in finding such an abundant supply of water from deep 
wells and so accessible to the city. 

We would therefore recommend the approral of these wells as an ad- 
ditional supply, and we believe it would be a better and safer permanent 
supply than the surface water now in use. 

(Signed) R. D. Kahle, 

E. T. Nelson. 



ST. B. H. 



66 ANNUAL REPORT 



KEPOET ON WATER SUPPLY OF LOUISVILLE. 

Ohio Statb Board of Health, 
Office of the Secretary, Columbus, 0., November 1, 1894. 

3^ the Council of Louisville, Ohi» : 

Gentlemen : Plans for the water supply for your village were submitted to the 
■State Board of Health October 25, 1894, by your consulting engineer, Mr. L, E. Chapin. 
The plans were approved by the Board subject to a favorable report upon chemical 
examination of the proposed supply. 

Samples were collected from the wells from which it is proposed to supply your 
village with water, on October 26, and were submitted to Prof. C. C. Howard, of Colum- 
bus, Ohio. I enclose herewith a copy of his report, and beg to inform you that the 
proposed water supply for your village is hereby approved. 

Yours truly, 

(Signed) C. O. Probst, Secretary. 



CHEMICAL EXAMINATION. 

Columbus, Ohio, October 30, 1894. 
Dr. C. 0. Probst, Secretary State Board of Health : 

Dear Sir: I have examined the samples of water received from Louisville, O., 
with the following results : 

No. 1. Sample, drilled well, 120 feet deep. 
No. 2. Sample, " " 110 " " 

Parts per 100,000. 



To. 


Oxygen 

required. 


Free 
ammonia. 


Albuminoid 
ammonia. 


Nitrous 
acid. 


Nitric 
acid. 


Chlorine. 


Total 
solids. 


1. 


.08 


.017 


.008 


none 


.014 


.16 


29.0 


2. 


.06 


.010 


.006 


none 


.021 


.14 


26.0 



It will be noted that all the constituents in both these samples are quite low, with 
the exception of the free ammonia. I am informed that the water is from a deep weil, 
and noting this fact as well as the very small quantity of all other constituents, I 
believe that no exception can be taken to this rather large quantity of free ammonia. It 
will be noted that all the quantities, with the exception of the nitric acid, are lower in 
the second sample than in the first. I have your explanation of the relations between 
the two waters and can only remark that the water with which the first sample is mixed 
to form the second must be a water of very fair quality. The constituents of both 
samples are so low that each must be pronounced a good water. 

Yours truly, 

(Signed) Curtis C. Howard. 



OHFO STATE BOARD OF HEALTH. d*] 

REPORT OF AN EXAMINATION OF THE PROBLEMS INVOLVED 
IN THE SELECTION OF A WATER SUPPLY 
FOR NAPOLEON. 

BY EDWARD T. NELSON, COMMITTEE. 

At the request of the mayor of the city, and on the information that 
the oonAracts for a public water supply were about to be let, I visited 
Napoleon, Ohio, on the 24th of July, 1894. Very fortunately for me, Mr. 
J. E. Strawn, of Salem, Ohio, the engineer of the proposed water works, 
and one of the best known of our sanitary engineers, was in the city at 
the time. I desire at the outset to record my thanks to Mr. Strawn for 
his great kindness in showing me the plans, elevations and detailed 
drawings, but more especially for his efforts in showing me all points of 
interest in connection with the location of the intake pip^ and the 
possible sources of danger to the water supply. 

Napoleon, the county seat of Henry county, is located on the north- 
ern bank of the Maumee river, and on the line of the Miami and Erie 
canal. The site of the town is sufficiently elevated above the river valley 
to afford good drainage. The streets are broad and well kept, and the 
aspect of the place is one of general thrift and improvement. The Mau- 
mee river is from 650 to 700 feet wide at this point, and has a depth of 
water ranging to 12 feet. To a limited extent, the water must be termed 
"slack water" owing to a dam fourteen miles further down the river, in 
the direction of Toledo. There is a strong surface current, but it is prob- 
able that the great depth of the water in the channel at all seasons of the 
year is owing to the influence of the dam. One thing in regard to the 
situation at Napoleon must be described in order that the members of 
the Board may gain an understanding of the questions involved. The 
canal lies at the foot of the slight elevation upon which the town is 
. ocated and between the town and the river. The canal thus receives the 
entire surface drainage of the town, and also, to-day whatever sewage 
i-here is, with a very slight exception to be noted further on in this report. 
It may be remarked in passing, that the drainage between the canal and 
the river is also partly back into the canal. The intake pipe will be 
located above the town, and is to be carried out into ttie river about 225 
feet, to a point where there will be not less than ten to twelve feet of 
water at the lowest possible stage of the river in midsummer. The pipe 
to be used is 14-inch. It will be carried in a trench under the canal to 
the pump-house just north of the canal bed. 

The current, at this point in the river, seems stronger than at any other 
within reach, and the bed is a pure sand, sharp and clean, without the 



6S ANNUAL RErORT 

Blightest admixture of mud or other surface deposit. The supply of sand 
for builders and plasterers is taken from the bed of the river not far from 
the proposed location of the intake pipe. Above the proposed site for the 
works, there is nothing but agricultural lands for many miles, the nearest 
town being Defiance, which is more than twenty miles as measured by the 
river. As water supplies go in Ohio, this one must be regarded as far 
above the average in purity of the water, and in the absence of any vis- 
ible contamination. Defiance on the one side, and Toledo on the other, 
both obtain their water from the Maumee. A very short distance below 
the location of the pumping house, there is a natural ravine or small water 
course. It is carried under the canal in a pipe perhaps fifteen inches in 
diameter, and the water carried by it enters the river at a point at least 
300 feet below the mouth of the intake pipe. At present very little 
water passes down the ravine — none at the time of our visit — but there 
are already a very few house connections, and there may be more in the 
near future, if measures are not made at once to stop the danger. Another 
remarkable feature of the situation must be described. Just opposite the 
town, but a quarter of a mile below the water works, a number of manu- 
facturing establishments are run by water obtained from the canal, the 
waste water flowing then into the river. Among those seen and examined 
are the following : Two flouring mills, a woolen mill and a saw mill. 
With the exception of the woolen mill, these establishments pass the 
water from the canal over the wheels and on into the river exactly in the 
same condition in which it left the canal. The woolen mill adds certain 
wastes in the form of dyes and the washings of their material. At all 
these places the surface current was so strong that bran, coloring matter 
and sawdust were taken at once down the stream before they had time to 
settle to the bottom. At the foot of the main street of Napoleon there is 
a brewery planted on the bank of the river. Connected with.it there is a 
stable giving shelter to six or eight horses at all times. The manure from 
this stable is thrown out of a window down on the bank of the river and 
then into the water. The brewery company, by means of pipe and pump, 
obtains a supply of water from the river at the foot of the manure pile. I 
was informed by a number of citizens, that the water thus obtained is not 
used in the manufacture of beer, but only for washing out the kegs and 
barrels. I called upon the members of town council as far as they could 
be found, and also upon the trustees of the water works I found them, 
without exception, interested in the questions that brought me to 
Napoleon, and apparently willing to meet ail my suggestions in the spirit 
in which they were made. This is even more especially true of the 
mayor. Honorable Mr. Meekison. We discussed methods for protecting 
the water now flowing in the river, &fi.d improving it by all the power 



OHIO STATE BOARD OF HEALTH. 69 

possessed by a town of this size. It is to be hoped that an ordinance will 
be passed by the council at an early date in regard to the location and 
outlet of all future house drains and sewers ; as also one in regard to the 
contamination of the water in the river below the location of the water 
works. The health officer was sent on a visit of inspection to the brewery 
before I left the place. After thus visiting and examining the river both 
above and below town, I feel warranted by the facts in offering the fol- 
lowing resolution : 

Resolved, That the State Board of Health hereby approves the plans of the water 
works trustees of Napoleon, and also their plan of obtaining a public water from the 
Maumee river at the point shown upon the plans submitted. 



KEPOET ON PROPOSED WATER SUPPLY FOR WOOSTER. 

Ohio State Board of Health, 
Officb of Secbetaky, Columbus, O., October 31, 1894. 

Dr. James D. Beer, Chairman Water Extension Commission, Wooster, Ohio: 

Dear Sir: On the 27th of October, at your request, and following instructions of 
the State Board of Health, I visited your city and investigated its present and proposed 
public water supply, and respectfully submit the following report : 

The present supply is both inadequate and undesirable. From the character 
of the surrounding soil and the presence of leaching cess- pools in its vicinity, there is 
reason to fear dangerous pollution of the water in the large well. The water collected 
by your impounding reservoir is not of the best character, and this supply almost entirely 
fails in time of drought. But there is probably little question in the minds of your cit- 
izens that a new and additional water supply must be provided at once, and the only 
point to be settled is, where shall this be obtained. 

First, 1 desire to express the opinion that if a fairly pure water, at a reasonable cost, 
can be obtained in sufficient quantity to supply all present and probable future needs of 
your city, the present source of supply should be entirely abandoned. 

I was shown by your commission two possible sources of supply ; one from a mill 
race fed by Apple creek, and the other from wells in the Killbuck valley, on what is 
known as the Eicher place. There can be no hesitation in deciding between these two 
supplies if health interests alone are to be considered. And even from a financial stand- 
point, while the cost of introducing the former supply may be less than that of the lat- 
ter, it is always cheapest in the end to obtain the purest supply possible. 

The j^reek water is subject to pollution through miles of country which it would be 
impossible for you to protect. The epidemic of typhoid fever at Plymouth, Pa., teaches 
us that even with pure mountain streams an open water supply is not always safe. The 
proposed supply from wells on the Eicher place is free from any present danger of pollu- 
tion, and may be kept so by proper attention to surroundings. I feel, therefore, that I 
can safely recommend this as a source of water supply for your city, provided it can be 
made to yield a sufficient quantity. While there is considerable evidence to show that an 
abundant supply can be obtained from this source, this should be proved conclusively 
before extensive work is begun. 

The question as to whether a better or more available supply than either of those 
proposed could be found, has not been considered, as your commission carefully looked 
into that matter. 



70 ANNUAL REPORT 

A sample of water was taken from the head race at Phillip's mill on October 27, 
1894. This was labeled sample No. 1. A sample was also taken from ,'a test well, 
known as well No. 7, on the Eicher place at noon of the same day. This was marked 
sample No. 2. These were submitted to Prof. C. C. Howard, of Columbus, Ohio, for 
chemical e:samination. Prof. Howard has made the following report : 

Ociolm- ffi), 1894. 
Dr. C. O. Probst, Sea-et^iry State Board of Health : 

Bear Sir : I have made a sanitary analysis of the samples of water received from 
W^ooster, with the following result : 

Parts per 100,000. 



No. 


Oxygen 
reqnired. 


Free 
ammonia. 


Albuminoid 
ammonia. 


Nitrous 
acid. 


Nitric 
acid. 


Chloriire. 


Total 

soUds. 


1. 


.34 


.001 


.018 


trace 


.0S5 


.36 


27.7 


2. 


.06 


.001 


.005 


trace 


.015 


.20 


18.6 



In sample 1 the oxygen required and albuminoid ammonia are decidedly higher than 
will be found in a water of good quality, and these factors are of sufficient importance 
to regard the water as not a desirable one. In sample 2 it will be observed that all the 
constituents except free ammonia and nitrous acid, which are the same, are less than in 
sample 1. These are so low that the water is shown to be of very good quality. 

Yours truly, 

(Signed) Curtis C. Howard. 

It will be seen that the evidence from a chemical examination bears out the evidence 
of inspection as regards the comparative purity of the two proposed supplies, and war- 
rents condemnation of the creek water and approval of the well water. 

Very respectfully, 

(Signed) C. O. Probst, Secretary. 



REPORT OF AN INVESTIGATION OF A NUISANCE AT 

ALLIANCE. 

BY THE SECRETARY. 

The following petition from Alliance, the o««iginal returned at the 
request of petitioners, was received in July : 

To the State Board of Health : 

Gentlemen: The undersigned are residents of the city of Alliance, Ohio, and 
respectfully represent to your honorable body that there is constructed in said city of 
Alliance a stone drain beginning at a point south of East Market street, and at Mechanic 
avenue, and ranning thence to a point north of East Prospect street and west of Arch 
avenue, where it empties into an open stream which runs in a northerly direction 
through a portion of said city of Alliance, which is thickly settled with resident families. 

This stone drain is used by property owners along its course as an outlet for drain- 
age and for the sewerage of waste pipes, water closets and excreta in general. 

The result of this use of said drain is that at its mouth and along the course of the 
open stream running thence, there is a deposit of filth and slime and excreta that in 
warm weather gives rise to foul vapors, noxious gases and stench which is inimical to 
the health and comfort of those who reside along said open stream, and which is danger- 
ous to the general health of those residing in that portion of said city, and is a nuisance 
which should be at once abated. 



OHIO STATE BOARD OF HEALTH. 7 1 

Your petitioners further represent that the local board of health, and also the city 
council, have been appealed to for action in this matter, but have utterly neglected ai^ 
failed to take steps to prosecute any reform, and said stream is now beginning to give forth 
foul vapors and is a source of danger to the health and lives of those residing in its 
vicinity, and it should have immediate attention, which the council of said city of Alli- 
ance and the local board of health neglect and refuse to give. 

Your petitioners therefore pray that your body take such steps as may be necessary 
to protect them from the danger to their lives and health. 

(Signed) Alex. S«ott, Jas. H. Scott, 

A. B. Marshall, Jas. A. Parks, 

A. L. McDonald, Chas. W. Hourson, 

H. Hahn, A. B. Shilling, 

F. Lindesmith, James Kelly, 
James Hopper, L. W. Johnson, 
8. McDonald, Jos. Miller, 

G. McDonald, F. E. Hartzell, 

F. Fisher, Luther Lee Johnson, M. D., 

N. S. Kayler, H. H. Shafer, M. D., 

J. E. Fletcher, P. C. Ramsey, M. D., 

D. E. Anderson, P. J. Callahan, M. D., 

W. W. Laiabe, S. T. Keith, M. D., 

A. Weaver, J. H. Tressel, M. D., 
John V. Lewis, M. D. 

I went to Alliance July 9, and in company with Dr. Welker, who is 
health officer, Mr. Hartzell, one of the petitioners, and Mr. Sharer, exam- 
ined the nuisance complained of. The statements of the petitioners were 
well within the facts, as the run was in a very filthy condition. 

The health officer stated that their board of health was fully aware 
of the nuisance and the need for its aba;tement, but called attention to 
the fact that the city was at the time engaged in constructing a system of 
sewerage, part of which was already built, and that the sewage now enter- 
ing the run would soon be taken care of. As sewerage is the only proper 
way of removing the nuisance it seemed unreasonable on the part of the 
petitioners to expect council to go to the expense of covering over the 
run, as was proposed, or to compel property owners to adopt temporary 
expedients to care for house drainage, when they were being assessed for 
sewers which would permanently dispose of such matter. 

To this Mr Hartzell replied that the work was progressing so slowly 
that it would likely be a 3'^ear or more before the nuisance would be 
abated. 

The outfall sewer had already been constructed. This discharges 
into Mahoning river about the Walnut street bridge. The plans, how- 
ever, call for the extension of this sewer some distance to the north, dis- 
charging into the same river. 

On July 12, I wrote to the mayor and council of Alliance, calling at- 
tention to the law requiring them to submit the outlet of their sewerage 



72 ANNUAL REPORT 

system to the State Board of Health for approval. No reply was received 
to this communication. A letter was received from Mr. L. E. Chapin, 
consulting engineer, under date of October 3, in which he has the fol- 
lowing to say in regard to the situation at Alliance. 

" Another matter I wish to consider with you, is the matter of the sewerage plans 
and the disposal of sewage in the city of Alliance, Stark county. The general plans of 
the sewers were prepared and adopted by the council before the passage of the act 
rightly giving your Board the authority to pass upon such plans. I have recommended, 
since the passage of that act, that the town council submit to your board their plans 
for approval or such recommendations as the State Board thought desirable, but the town 
council, like other municipal bodies, is slow to incur an expense which may be avoided 
•or deferred. 

" Some eight or ten sewers have already been constructed in accordance with the gen- 
-eral sewer plans, which provide for a strictly sanitary system of sewers. The outfall 
sewer temporarily discharging into the Mahoning river at a point above the Walnut 
street bridge. The plans, however, call for the extension of this sewer some fifteen 
hundred feet further to the north, to an outfall in the Mahoning river at a point remote 
from any residence. This outfall sewer is also carried at such an elevation above low 
water in the river that purification works can be built on the lands adjacent to the 
outfall. 

" The city of Alliance, in addition to this sanitary system of sewers now started, has 
several storm water sewers ; one in particular which has a number of house connections, 
and the flow of which during certain seasons of the year is extremely objectionable, be- 
ing a decided nuisance. 

"The council had passed an ordinance and were in shape to. enforce it ; that is, as 
soon as the sanitary sewers were built along the property now sewered into the storm 
water sewers the connection to the storm water sewers should be cut ofi and the drainage 
of these properties be connected with the sanitary sewers, thus eliminating the nui- 
sance from these objectionable sewer connections. 

'' It has been the idea of the council that in the near future purification works for 
their sewage must be erected, inasmuch as they must drain into the Mahoning river, 
from which is largely dependent the water supplies of various towns and cities in that 
valley. But certain parties have commenced proceedings and secured a temporary in- 
junction restraining the city, first from allowing any sewage to enter the above men- 
tioned storm water sewers ; and second to restrain the corporation from discharging 
any sewage into the river through the sanitary sewers. 

" These sanitary sewers having been built by the issuance of bonds to be met by an 
aseessment upon the property benefited by the improvement, it leaves the city in bad 
shape, inafmueh as tLey can not spread an assessment upon the jiroperties for the cost 
and expense of constructing the sewers until the sewers can be used. Now the amount 
of sewage from the sanitary sewers for the next year will be very small, as there are but 
few connections now made with the system, and few will be made until next season. 
Therefore the question with me is, ' What steps can the council take under the statutes 
and circumstances, whereby they can derive the benefit from this much needed system 
of sewers?" 

Several of the officials are of the opinion that if the State Board of Health would 
take some action in the matter and make a recommendation to the town council, that 
the council could bring the matter of issuing bonds for the construction of a sewage 
purification works before the people at the November election, and that such a question 
anight be carried. Can your Board consistently make a recommendation to the council 
regarding the disposal of sewage, which recommendation could be published and there- 
by used as a means of convincing the people and electors of the necessity of such 
action?" 



OHIO STATE BOARD OF HEALTH. 73 

In reply I stated that the council of Alliance had already been noti- 
fied that this Board was prepared to take action with respect to the sew- 
erage system of Alliance, upon request from the proper authorities. The 
matter rests there. 



EEPORT ON AN ALLEGED NUISANCE AT ARLINGTON HEIGHTS. 

BY DR. BYRON STANTON, MEMBER OF STATE BOARD OF HEALTH. 

To the State Board of Health : 

Gentlemen : Having been appointed by President Nelson, on May 5, 1894, to 
make an investigation of a reported nuisance at Arlington Heights caused by The George 
Fox Starch Works at Lockland, I would respectfully report that on the 9th of May, in 
company with John H. Francis, health officer of Arlington Heights, I visited the starch 
works and found a small amount of waste from the works running into the stream which 
flows through Arlington Heights. 

As the amount of waste was small and the stream not very low, I was not able to 
detect any serious nuisance. Suggesting that my report to the Board should not be 
made until I had further opportunity to investigate the matter and requesting the health 
officer to notify me of further trouble from this source, the matter was held in obeyance. 

Having heard nothing further from the health officer, I called upon him in August 
and was informed that there had been no further cause for complaint. No further 
action, therefore, is necessary by this Board under existing state of aff'airs. 
Eespectfully submitted. 

B. Stanton, M. D. 



REPORT OF AN INVESTIGATION OF AN ALLEGED NUISANCE 
AT BELLEFONTAINE. 

BY THE SECRETARY. 

Early in July complaint was received from Bellefontaine that a 
sewerage system was heing constructed for Bellefontaine, and that it was 
proposed to discharge the sewage into a run which flows through the 
village. It was further alleged that this run was already receiving a large 
amount of sewage and other filth, and was the source of a nuisance 
detrimental to the health and comfort of a large number of people. 

Thinking from the reports that this was a case for the State Board to 
deal with, the President and myself went to Bellefontaine on July 28. 
We found that the situation had been, in part, misrepresented. The 
village was not about to construct a sewerage system, although a nuisance 
had undoubtedly been created by the pollution of the run. This run, 
known as Possum run, passes through the village in a southwesterly 
direction, and is receiving a large amount of filthy drainage. It is a 
natural water course, serving to carry ofi" a good part of the surface drain- 



74 ANNUAL REPORT 

age of the town ; but it has been converted into an open sewer. Numerous 
privies are built over it, and a number of house drains open into it, 
including tiie water closet drainage from the court house and jail. 
Towards its lower end it also receives a considerable amount of drainage 
from the gas works, which further cowupts it. 

In the central part of town the run has been arched over. At the 
time we saw it there was practically no water in it excepting what entered 
from drains and sewers. 

We inspected the run for its entire length in the village, being 
accompanied by the health officer, members of the board of health and 
several interested citizens. We afterwards met the board of health and 
discussed measures for abating tlie nuisance. The board of health had 
adopted an order to exclude all filthy drainage from the run, but it seemed 
doubtful whether this order would or could be enforced. The only radical 
cure for the trouble is a comprehensive system of sewerage, and the board 
of health was urged to use every efifort to secure this needed improvement. 

The town is supplied with excellent artesian water and will probably 
soon be driven to the construction of sewerage. 



REPORT OF AN INVESTIGATION OF A NUISANCE AT VINTON. 

BY THE SECRETARY. 

« 

August 23, I was summoned to Vinton, Gallia county, by the board 
of health. The board wanted advice in regard to enforcing its order to 
abate a nuisance. 

The facts in the case are as follows: Mr. S. owns a dam on Raccoon 
creek which furnishes, in part, power to run a flour mill, woolen mill 
and planing mill, combined. Many years ago this creek made for itself 
a new channel, leaving a loop of its old bed cut off from its flow. This 
loop receives drainage from adjacent highknd, and in addition is subject 
to overflow from the creek during freshets. As a result, two large stagnant 
ponds have been created and maintained in the village. A large amount 
of decaying vegetable matter is gradually uncovered as the water is 
lowered by evaporation, and the board of health was of the opinion that 
this was the cause of malarial fever prevailing in the village. The pro- 
longed drought of this year caused the water in one of these ponds to 
become almost completely evaporated; considerable remaining in the 
other. 

The board of health ordered the owner of the dam, who also owns 
the land on which the ponds are located, to abate the nuisance by cutting 



OHIO STATE BOARD OF HEALTH. 75 

a channel between the creek and the ponds above the dam, so that the 
water in the ponds could be freshened. The order had not been obeyed, 
and the owner threatened to contest it hi the courts. 

In company with the mayor, members of the board of health, Mr. S. 
and others, I examined the bayou, as it is called. The conditions were 
as descri'bed above. No bad odors were noticeable. I questioned the 
physicians, and others, with reference to the prevalence of malarial fever 
in the village. The mayor, Dr. Button, who is a member of the board of 
health, and several citizens agreed in the statement that fully four-fifths 
of the inhabitants were suffering, or had recently sufifered from malaria. 
Three or four were said to be in bed with the disease, and I found a 
number who testified to knowing of those who were having the "shakes" 
or intermittent fever. Drs. Hamilton, however, (who are, by the way, 
related to Mr. S.) said there was not much malarial trouble in the village ; 
at least no cases of pernicious fever. Malaria has undoubtedly prevailed 
in the village for years, and in my judgment the bayou is largely respon- 
sible for it. I dorfbt very much whether the plan proposed by the board 
of health will stop the trouble. The daily lowering of the water in the 
dam will cause areas in the bayou, covered by decaying vegetation, to be 
daily uncovered and exposed to the sun ; conditions favorable for the 
development of malaria. 

The plan for abating the nuilsance was a compromise measure. Some 
of the board favored drainage by tiling the bayou, but the owner claimed 
this would destroy his dam, as the winter freshets would cut a channel 
through the bayou and leave his dam without water, and the board were 
fearful that the corporation, if this should result, would have heavy 
damages to pay. 

I advised the board to proceed in the enforcement of its order; to get 
the opiaion of a competent engineer as to the danger of destroying the 
dam by draining the bayou, and if the nuisance was not abated by fresh- 
ening its waters, as proposed, to amend their order and require the owner 
to drain the bayou. 

I then called upon Mr. S., owner of the dam and bayou, and talked 
the matter over with him. He claimed that the order was in the nature 
of spite work on the part of certain members of the board of health. I 
assured him that in my opinion the bayou was accountable for the 
malaria which prevailed in the village, and that the board had authority 
to compel him to abate the nuisance. He said he would consult his 
attorney, and would carry out the board's order unless advised not to 
do so. 



76 ANNUAL REPORT 

The clerk of the board of health, Mr. E. G. Shaner, under date of 
October 12, reported that nothing had been done by the board, and that 
they were still having cases of malarial fever. 

The owner of the dam consulted an attorney, who advised him to 
resist the order on the ground that the board of health was not legally 
organized, there having been but four out of six councilmen present when 
the board was established. Also because the village did not have five 
hundred inhabitants. I consulted the Attorney General, who advised 
that these objections were without grounds, as four of six councilmen are 
competent to pass ordinances. The limitation as to population was 
removed by the amendnients to the health laws, passed March 4, 1893. 
I notified the Vinton board of the Attorney General's decision and ad- 
vised them to proceed with the prosecution. 



REPORT ON A NUISANCE AT WOODSFIELD. 

BY THE SECRETARY. 

I was called to Woodsfield, Monroe county, by the mayor, on a mis- 
sion very similar to that which took me to Uhrichsville, namely, the 
members of the board were not sure as to their powers and duties, and 
some questions had arisen, in the settlement of which they required help. 

Alter inspecting the village in company with the mayor, Mr. Walton, 
and the health ofiicer, Dr. Huth, I met the board of health. 

The storage of fertilizer-bone-dust within the corporation was one of 
the questions troubling the board. Woodsfield is a distributing point for 
quite a good deal of this material, and some of the principal business men 
are engaged in it. It is stored in half a dozen small wooden houses, 
located on railroad property near the railroad depot. The odor from these 
houses is intolerable to a number of families living in their vicinity. The 
board had ordered the removal of these houses, but the order was not 
obeyed. 

I advised the board that the houses did not constitute a nuisance, 
but the fertilizer stored in them, and that their order should be amended 
to prohibit the storing of fertilizer at the places named, and to follow up 
this order, if not obeyed, by the arrest of persons failing to comply. 

The other question the board had not been able to settle was a 
nuisance arising from the disposal of excreta at the court house. A year 
or more ago the commissioners introduced the Smead dry closet into the 
court house. There is only the dry closet feature of the Smead system, 
the building being heated and ventilated by other means. The court 



OHIO STATE BOARD OF HEALTH. 'J'] 

room is an exception, it being ventilated by connecting it with the 
ventilating stack. 

This system of excreta disposal has caused such annoyance to the 
people living near the court house, arising from bad odors which have 
been noticed squares away, that the board of health ordered the commis- 
sioners to remove it. This had not been done* Only on one or two 
occasions were bad odors noticeable in the court house itself. 

Several factors seemed to enter into the cause of the trouble : 

1st. The s)'stem is over-taxed. The closets, being very convenient, 
are used by a large number of the town people. 

2d. The excreta have been allowed to accumulate, and in burning 
out a mass of fecal matter with slow fire great volumes of noxious gases 
were created, and, in certain conditions of the atmosphere, settled down 
upon the town. 

3d. The ventilating stack is but sixty-two feet high, and the cupola 
of the court house is ninety feet, so the gases are discharged too near the 
ground. 

4th, In operating the closet excreta are received on fire brick kept 
red hot by a gas jet beneath, for the purpose of drying the deposit. 

It was decided to try running the closets without heat, except in the 
ventilating stack, and to burn the deposits at short intervals with the aid 
of kerosene. If this was not successful, Mr. Smead was to be requested to 
attempt to remedy the matter. If the nuisance still continued to exist, 
in spite of all changes in operation or construction, the board of health 
was advised to enforce its order for the removal of the apparatus. 



CONSUMPTION AND ITS PREVENTION. 

BY THE SECRETARY. 

Although it has been fully twelve years since Koch announced that 
he had discoverd the cause of consumption to be a vegetable parasite 
which at once suggested the possibility of its prevention, it is only within 
the last year or two that health authorities of this country have taken 
active measures to restrict the ravages of this monster plague. 

While the medical world has accepted the parasitic origin of consump- 
tion, and also the fact that the disease may be, and usually is, indirectly 
communicated from one person to another, and is therefore preventable 
the great masses of the people do not yet realize this. It is not believable 
that a disease which may be prevented, and which destroys one-seventh 



78 ANNUAL REPORT 

of all whOfdie, would be permitted to continue its ravages uncliecked if 
the people were really convinced that its prevention in very truth is 
possible. Until'such knowledge can be brought home to them, health 
authorities can acoomplish comparatively little in the prevention of 
consumption. 

Few realize the extent to which this disease prevails. Dr. Billings, 
who has charge of the vital statistics collected at the census, estimates 
that]|125,000 persons died from consumption in the United States during 
the year 1890 ; and about one-seventh of all deaths are due to this disease. 

The following table, made up from reports published in Ohio statis- 
tics, shows the number of dea^s reported annually in Ohio from con- 
sumption and other tubercular diseases during the ten years, 1884-1893: 



OHIO ST^'ATE BOARD OF HEALTH. 



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8o ANNUAL REPORT 

A much greater number of deaths occurred than is expressed in the 
table, and it is safe to say that more than 50,000 persons died in Ohio 
from consumption during the ten years ending with 1893. 

The State Board of Health, during the present year, has devoted 
itself to the task of disseminating information concerning the contagious 
nature of consumption, and the means to be employed to limit its spread. 
First, the medical profession was appealed to for assistance in the following 
circular letter, which was sent to each physician in Ohio: 

Ohio State Boakd of Health, 
Secretary's Office, Columbus, O., March 12, 1894. 

Dear Sir : The State Board of Health desires to inquire into the extent of phthisis 
pulmonalis in Ohio, with the view of taking some action to limit, if possible, its exten- 
sion. As the required information can only be obtained from practicing physicians, 
and as their assistance is essential for the success of any effort made for the prevention 
of the disease, we hope to secure your cordial co-op?ration in this undertaking. 

Experiments in tuberculizing the lower animals show conclusively that for animals 
the disease is both inoculable and infectious; and there is evidence, both clinical and 
experimental, sustaining the view that tuberculosis is also communicable from man to 
man and from animal to man. While heredity, bad sanitary surroundings and other 
adverse conditions of environment undoubtedly play an important part in its develop- 
ment, it may be asserted that tuberculosis never occurs in the absence of the specific 

bacillus. 

Dr. Billings states that 101,645 deaths were reported from consumption in the 
United States during the census year 1890, and estimates that the correct figure is not 
less than 125,000. No figures are given for the deaths from other forms of tuberculosis. 
In Ohio, for the year ending March 31, 1891, assessors reported 8,650 deaths from con- 
sumption. Assuming that the omissions in reports of deaths from consumption in 
Ohio are in proportion to the omisssons in reports of deaths from all causes, we must 
add not less than 2,000 additional deaths due to this cause. 

What can be done by the health authorities and attending physicians to stay the 
progress of this great plague? 

As it is estimated that for one that dies of consumption two will be sick, it may ap- 
pear a well nigh hopeless task to control this army of invalids, and the most that can 
be expected is that a continued and systematic effort will prevent a certain, we hope a 
considerable, number of new cases each year. There are but few consumptives who do 
not come under the eye of a physician, and if each patient can be imbued with the idea 
that his disease may be communicated to others, and especially to his loved ones, and 
that this can be prevented by proper care, much will have been accomplished. As the 
bacilli of pulmonary tuberculosis are practically found exclusively in their sputa, it is 
unnecessary to place restrictions upon the movements of consumptives if they can be induced 
to properly care for and destroy these infectious sputa. While this may not be possible in all 
cases, it is believed that an efiort to this end will result in much good. 

In the line of education the State Board of Health could prepare a pamphlet on The 
Prevention of Consumption, couched in simple language, enforcing the fact of the com- 
municability of the disease, and giving plain instructions for caring for the sputa, and 
for necessary disinfection of rooms, soiled clothing, cuspidors, etc. Copies of the pam- 
phlet could be furnished to physicians, enabling them, if desired, to leave proper instruc- 
tions with the family in printed form. The pamphlets could also be supplied to each 
board of health in the State (there are now such boards in all cities and in nearly all 
villages and townships), with instructions to place copies in all families in which the 
disease is reported. 



OHIO STATE BOARD OF HEALTH. 8 1 

To accomplish this it would be necessary for physicians to report all cases of con- 
sumption to the local health authorities. 

Although there may be some objections urged against the registration of consump- 
tives, it is believed that such a measire will afford the bs.-it opportunity for controlling 
the disease. Wbile boirds of health will not be expected to use compulsory measures 
in the prevention of consumption, they are clothed with authority which enables them 
to do so in exceptional cases; as for instance, upon the request of the attending physi- 
cian, requiring the disinfection of a house in which adeath has occurred from this disease 
before it is oc< upied by another family. Boards of health would also be able to provide 
the poor with necessary disinfectants, where disinfection would likely be omitted on ac- 
count of the expense. Many other ways would doubtless appear, if cases of consumption 
were reported, in which the attending physician and health authorities could work to- 
gether for the prevention of other cases of the disease. 

It may also beconsiderel wise to dif-tribute a pamphlet to managers of railroads and 
factories, to proprietors of hotels, theaters and other places of public resort, urging that 
proper precautionary measures be taken to protect the public against tubercular 
infection. 

If consumption is communicable from person to person, it is preventable ; and if the 
public can he brought to a realization of this fact we may hope that the law of self-pres- 
ervation will interpose a check to this, the greatest scourge of mankind. 

The medical profession has always been foremost in all matters of sanitary reform, 
and we hope for your advice and assistance in this proposed measure against con- 
sumption. 

Please fill out the enclosed blank and return it to this office as Boon as convenient. 

By order of the Board. 

Yours respectfully, 

C. O. Probst, M. D., Secretary. 

(BLANK.) 

1. How many cases of consumption are you treating at the present time ? 

2. How many cases did you treat during the year 1893 ? 

3. Do you think it would be advisable for physicians to be required to report to the 
local health authorities all cases of consumption coming under their care ? 

4. Do you believe that objections would be urged against such reports, and if so, 
what? 

5. If supplied with printed instructions for the prevention of consumption, suitable 
for the laity, will you be willing to leave a copy with each family into which you are 
called on account of consumption? 

6. What suggestions have you to offer as regards practical measures to be taken for 
the prevention of consumption ? 

7. Please give a brief history of any case or cases occurring under^our observation, 
showing consumption to be a communicable disease. 

Name ^ M. D. 

Residence , , _ Ohio. 

I>ate ^1894. 

Eleven hundred and eighty-two ansv^'ers were received, representing 
nearly one-sixth of the entire profession. With but few exceptions this 

6 ST. B. H. 



82 ANNUAL REPORT 

number have pledged themselves to aid the Board in any effort it may 
make to prevent the spread of this disease. In addition to the answers to 
the inquiry, a number of letters have been received from physicians, ex- 
pressing themselves as heartily in favor of such a movement. 

Analyzing the reports it is found that eleven hundred and eighty- 
two physicians, were, at the time of the inquiry, treating nineteen hun- 
dred and twelve (1,912) cases of consumption. Assuming this to be the 
average for the entire profession, it indicates that between ten and eleven 
thousand consumptives are continuously under treatment in this State. 
Fifty-three hundred and forty-two (5,342) cases are reported as having 
been under treatment during the year of 1893. As many of these cases 
■were doubtless seen by more than one physician during the year it would 
be misleading to multiply this by six, as in the previous estimate, but 
even allowing that each case was seen by two physicians, and so reported 
twice, we have an estimate of over sixteen thousand (16,000) consumptive 
patients treated during the year 1893. 

The majority — 764— favor requiring physicians to report cases of con- 
sumption to the local health authorities ; but nearly as many— 668 — are 
of the opinion that objections would be urged against this requirement. 
Various objections are mentioned : 

(a.) Depressing eff"ect upon the patient. 

(&.) Branding a family as tuberculous and lessening chances of other 
members to enter matrimony. 

(c.) Physicians who were known to always report their cases would 
not be called into many families where consumption was suspicioned. 

(d.) Physicians would wait too long in diagnosing diseases, endan- 
gering friends and relatives in the meantime. 

(e.) Unless isolation of patient was intended, of no particular use. 

Many other objections were mentioned. 

All but fifty-eight of the eleven hundred and eighty-two physicians 
reporting expressed a willingness to place printed instructions for the 
prevention of consumption, as prepared by the Board, in the families into 
which they were called on account of consumption. This is most gratify- 
ing, and an indication of the direction our efforts should take. Four 
hundred and seventy-seven furnished reports of cases showing the com- 
municability of the disease, and this is one of the most valuable results 
of the inquiry. These reports afford the most convincing evidence that 
consumption is a contagious disease ; and that without proper precau- 
tions every patient is a source of danger to those about him. 



OHIO STATE BOARD OF HEALTH. 83 

The information received by the inquiry may be briefly set forth as 
follows : 

Number of answers received to circular sent to each physician in Ohio... 1,182 

Number of cases treated during the year of 1893 5,342 

" being treated at present time 1,912 

Number of physicians who favor reporting all cases of consumption to 

the local board of health 764 

Number who belieVe objections would be raised to such reports 668 

Number unwilling to leave instructions, if provided 58 

Number who believe consumption to be a communicable disease 640 

Number giving cases showing that it is communicable 477 

Number of cases given showing the communication of consumption from 

husband to wife 116 

Number of cases given showing the communication of consumption from 

wife to husband 37 

Number of cases given showing the communication of consumption to 

nurse, relative or friend 274 

Number of physicians who believe the disease to be communicable, but 

do not give examples; , 127 

Number of physicians who believe the disease to be hereditary 38 

Nuicbtr of physicinns who do not believe that consumption is communi- 
cable 36 

The following is a list of cases, arranged alphabetically as to residence, 
showing the contagiousness of consumption, reported to the State Board 
of Health by physicians of Ohio : 

DISEASE TRANSMITTED BY HUSBAND TO WIFE. 

BeUe Centre, S. J. Pollock, M. D. 

"I attended a man with consumption ; his wife, a stout, healthy woman, of strong 
race, in a short time after his death succumbed to consumption. " 

Bdle Centre, W. S. Philips, M. D. 

"Husband died about four years ago. Since then the wife, of good history, is a vic- 
tim of the disease. " 

BeUvUle, E. Stofer, M. D. 

"A lady, previously in good health, nursed her husband who had tuberculosis, and 
apparently contracted the same disease. Died four months a(ter his death. " 

Bridgewater, M. L. Holt, M. D. 

''Mr. S., of strong and healthy parents, began to decline and died in about two years 
of consumption. Wife, of healthy parents, followed in two years of the same disease. 

'Mr. G., of strong and healthy family, began to decline and died, and his wife fol- 
lowed in two or lets years. Wife was of pulmonary diathesis. 

'Mr. T., consumptive diathesis, died, and his wife, of healthy parents, followed in 
less than two years. 

' Mr. P. came from the army in 1865 with consumption; of pulmonary diathesis, 
died in one year. Wife, of healthy family, died in two years of cansumption. " 



84 ANNUAL REPORT 

Byhalia, E. L. Mather, M. D. 

" A comsumptive married a perfectly healthy wife. No history of consumption in 
family. Wife nursed him and in a short time developed consumption and died of 
same. " 

Caledonia, G. Hahn, M. D. 

"A young man of consumptive family married a girl in whose family there had 
never been anything like consumption, and in less than a year they both died of the 
disease. " 

Canton, E. 0. Morrow, M. D. 

" A strong, healthy woman, good family history, who slept with and nursed her 
husband during a six months' seige of consumption, died of the same disease within a 
year and a half after. " 

Canton, A. B. Walker, M. D. 

" Miss R. married into a consumptive family, her family history being good. Her * 
husband died two years after their marriage, of consumption, and in eighteen months 
she married again. Within two years and a half she died of the disease, and three 
years later her second husband died of the disease, with no history in his family of the 
disease." 

Carey, John N. Kerr, M. D. 

" Mrs. S., not of tubercular family, waited upon and slept with her husband who 
died of consumption. She now has pulmonary tuberculosis. " 

Cincinnati, Otto Juettner, M. D. 

"N., daughter of healthy parents, married L., who a year after marriage developed 
svmptoms of bacillary phthisis. At present the wife is under treatment for incipient 
tuberculosis." 

Cincinnati, B. F. Lyle, M. D. 

" No inherited tendency, husband died two years previously of consumption and 
was nursed by his wife, who contracted the disease." 

Cincinnati, G. G. Moode, M. D. 

" Have se^n a healthy, robust girl marry a tuberculous man (chronic) and die from 
consumption before he died, and I have known of vice versa examples." 

Cincinnati, A. F. Juettner, M. D. 

" G. M. died of tuberculosis. His wife also died of tuberculosis after him. She 
coming from a very healthy and robust family." 

Cleveland, G. 0. Fraser, M. D. 

" Mrs. B. attended her husband, was healthy and strong, but died from phthisis inside ■ 
of a year. Could give many more cases that were so striking that my mind was settled 
on this point fifteen or twenty years ago." 

Cleveland, J. B. McGee, M. D. 

" Husband died of tuberculosis, and six weeks after the wife had typical symptoms, 
but in two months this all cleared up and she was discharged well. Whether she re- 
mained so, do not know." 



OHIO STATE BOARD OF HEALTH. 85 

Columbus, Starling Loving, M. D. 

"A husband developed bronchial tuberculosis, was carefully nursed by the wife (in 
good health) for eight months, when he died. Six months afterward the wife had 
pneumonorghia and other symptoms of tuberculosis, and at the end of six months more 
died." 

Columbus, Noah Elliott, M. D. 

" A patient of mine contracted consumption. He was waited upon by his wife, a 
strong, healthy woman, but two years later she died of the same disease." 

Columbus, JR. Harvey Reed, M. D. 

" A healthy wife nureed a consumptive husband. Husband died, and afterwards 
wife and child. All of consumption." 

Columbus, J. U. Barn hill, M. D. 

"J. E., belonging to a family free from tubercular affections, died of acute tubercu- 
losis, and five or six monihs after his wife died of the same disease." 

Dayton, A. M. Williamso'n, M. D, 

" I remember a case of a gentleman dying of consumption, who was attended and 
nursed by his wife. Three years subsequently she died of consumption and I could not 
trace any heredity in her case." 

East lAverpool, J. E. Toot, M. D. 

" Mr. F., in whose family there was a history of consumption, married a lady whose 
history was clear. Both died of the disease." 

El^ria, 0. T. Maynard, M. D. 

" Husband had consumption for two years. W ife came down with well developed 
phthisis before he died ; previously good health and a clear family history. Another 
case, very similar, where wife came down with disease soon after husband's death." 

Gillef^pievUle, J. M. Wiltshire, M. D. 

" I was called to treat a gentleman for acute tuberculosis. He died in a few months, 
leaving a wife and four children apparently in good health. One and another of them 
died, in quick succession, of the disease." 

Hamilton, W. J. Kumler, M. D. 

" Mr. T. died of consumption Mrs. T., who slept with her husband and was con- 
stantly with him, now has a well developed case. There was no trace of the disease in 
her family." 

Barpersfield, L. L. Bennett, M. D. 

" Husband died of consumption ; later his wife died of same disease. Undoubtedly 
communicated." 

Harriet&viUe, 7. W. Brock, M. D. 

" I recall one case where a husband communicated the disease to his wife, whose 
family history gave no indications of the disease." 

Harrison, J. C. Kilgour, M. D. 

" A wife whose husband died with the disease followed him in the same way, three 
years later, with no history of the disease in her family." 



86 ANNUAL REPORT 

Hebron, LeRoy W. LeCrone, M. D. 

"Mr, E. died of consumption (slow). Mrs. E. is now very low with same disease. 
No heredity in either family, and only communicable under reduced physical condi- 
tions." 

Hixon, Chas. D. MeDougall, M. D. 

" Husband after four years died of tuberculosi?. Wife, with no history of tubercu- 
losis on either side, died in fourteen months after husband, of tuberculosis. She married 
a second time and six months before her death, the man, of good history, showed signs 
of tuberculosis that are gradually progressing." 

Ironlon, D. R. Alban, M. D. 

"Mrs. S., consumptive, came under my care. Her family history good, but her hus- 
band died ten months previous with pulmonary tuberculosis. It is very evident that 
Mrs. S. contracted the disease from her husband." 

JoMkson, William Phillips, M. 1). 

" A lady who attended her husband, who died of tuberculosis, was stricken with 
acute tuberculosis and died within four months. No history of consumption in her 
family." 

Jusht^, Walter G. Lowe, M. D. 

" A young minister married a strong young lady. The husband soon developed into 
a full fledged consumptive. The wife nursed him until his death, and soon followed 
him." 

Livm, D. W. Steiner, M. D. 

"Mrs. M., no family history of tuberculosis, nursed her husband, who died, and soon 
after contracted the disease and died within a year of consumption." 

Linndah, J. V. Matt, M. D. 

" A case of wife contracting the disease from her husband." 

Magnolia, D. L. Mcllravy, M. D. 

" A man, who had the trouble three or four years, was nursed by his wife, in whose 
family there was no predisposition to the disease. She began to cough and lose flesh, 
and is now under my care." 

Marion, J. W. Thatcher, M. D. 

" A perfectly healthy young lady, with no hereditary tendency to consumption, three 
years ago married a consumptive man who has just died from the disease. She now has 
incipient consumption. No doubt communicated from her husband." 

Martinsburg, N. S. Toland, M. D. 

" I had a brother die of the disease who had been married to a very healthy woman, 
in whose family consumption was not known; she soon after died of the same disease. 
Others 1 could refer to." 

Marysville, H. A. Badebaugh, M. D. 

"A man died in '93 of consumption. He was confined to his room and bed all 
winter, attended by his wife, a robust German woman in whose family consumption was 
unknown. She died of the disease within the year." 



OHIO STATE BOARD OF HEALTH. 87 

Minersiille, W. B, Rosamond, M. D. 

< " Husband died of consumption. Wife, of a strong and healthy family, died later 
of same disease." 

Minster, C. L. Davi?, M. D. 

" A man belonging to a consumptive family, soon after his marriage contracted the 
disease; his wife nursed him contracted the disease, and died before her husband. I haye 
observed many such cases." 

Mount Victory, J. J. Borne, M. D. 

" E. G., age twenty-four, contracted consumption, and his wife, age twenty-two, I am 
positive contracted the disease from him and died. Wife's family has no history of con- 
sumption for a number of generations." 

Newark, S. C. Priest, M. D. 

"A wife remained constantly in a close room with a husband. She neglected her- 
self in regard to pure air, food or clothing, began to run down, took cold, and died five 
years after husband." 

Nevada, R. L. Souder, M. D. 

"F., age about thirty, was ill of consumption and died. His wife was attacked with 
pulmonary hemorrhages, rapidly developed signs of pulmonary tuberculosis, and died 
the following year." 

New Burlington, S. G. Sewell, M. D. 

" F. H., after a lingering illness of tuberculosis, died. His wife nursed him, and 
during the last days of his illness developed a cough, and in about a year succumbed to 
the disease. Her family history was perfect as regards diseases of . that character. I 
have seen other examples and am thoroughly convinced that tuberculosis is con- 
tagious." 

New Petersburg, Eufus A. Dmyer, M. D. 

" I have treated a great many cases and have known a healthy woman to oontract 
consumption from her husband. It is contagious and infectious beyond doubt." 

New Plymouth, E. A. Frampton, M. D. 

" I treated a gentleman for consumption. Soon after his death one of his sons took 
it in an acute form and died. The wife and mother, who nursed the father and son, died 
with the same disease. She appeared well during my first acquaintance with her, but 
not long since one of her sisters died with the same disease." 

New Springfield, Wm. R. Granger, M. D. 

" I treated a young married man who died of tuberculosis. His young healthy- 
wife, of a very robust and healthy family, died in a short lime; presumably contracted' 
the disease from kiseing her husband." 

North Fairfield, E. A. Smedley, M. D. 

" Mrs. T., with the best of family history, perfectly healthy herself, married a man 
with tuberculosis. She nursed him and within eighteen months after his death she had- 
tubercular hemorrhages from her lungs." 

Norwood, J. C. Gadwallader, M. D. 

"A young man, married last October, has consumption. No history of the disease 
in wife's family, though she at this time shows incipient phthisis." 



88 ANNUAL REPORT 

Oberlin, Julia Ohapin Jump, M. D, 

"Mrs. V. nursed her husband through his illness. He died of tuberculos's and five 
years later she died of the same disease. No consumption in her family." 

Old Fort, J. W. Kippel, M. D. 

" Young lady married a tubercular man, lived with him two years until he died. 
Her family history shows no trace of the disease. Two week after husband's death, whom 
she had nursf d, she took to her bed and in seven weeks died of phthisis. 

Platlsburgh, H. F. Wildasm, M. D. 

" I saw a case where a man and two or three of his brothers died of consumption. 
His wife waited on him, slept with him, she being a stout, healthy woman when she 
married, with no trace of the disease in her family, but two years after his death she 
died of the disease." 

Pleasanion, E. M. Bean, M. D. 

"I knew a man, who died of consumption, and a short time after the wife, a strong 
woman at the time of his sickness, died of the same disease." 

Pomeroy, Richard Owen, M. D. 

" Last year I had a case where the man died of consumption, and the wife is now 
suffering and will probably die with the disease." 

Portsmouth, S. S. Halderman, M. I). 

"Mrs. B., with a clear history of no heredity, died within two years after contract- 
ing cough from tuberculous husband, whose death preceded hers. I could give at least 
a half dozen similar ca-es." 

Ravenna, George Sadler, M. D. 

"I have a case in a man, and his young wife, formerly healthy, is contracting the 
disease from her husband." 

Reitey, David D. Borger, M. D. 

" Mr. B.. family history tuberculous, first wife had no history of consumption in any 
part of the family, yet she died in six years of the disease. Second wife was of non 
tuberculous family; at the time of her marriage was a marvel of health. Mr. B. died 
two years and a half later leaving his second wife in first stages of consumption, but her 
robust constitution and good care and treatment has carried her back to tolerable fair 
health." 

Reynokhhurg, J. B. Dymrt, M. D. 

"One case where I believe a wife contracted the disease from her husband." 

Rwral Dale, James F. Leeper, M. D. 

"In two cases the husband died with consumption and in one case, within four 
months after, the wife had hemorrhages of the lungs and died, and in the other case the 
wife died within six months." 

Rushylvania, J. G. Sutton, M. D. 

" Mr. G. had consumption, and died within two years after his marriage. One year 
later his wife died of the same disease. Her family history free from the disease. I 
could give many other similar cases." 



OHIO STATE BOARD OF HEALTH 89 

Rushville, W. C. Lewia, M. D. 

" I have known strong', healthy women, without herei^ity, marry men who have died 
within five years. These wives waited upon their husbands, contracted the disease, and 
died within two years. There seem to be more women than men contract the disease 
in this way. I could say a good deal on this subject." 

Sidney, M. F. Hussey, M. D. 

"A case came under my observation long before I began to practice. I had a sister 
who was absolutely free from it, and in whose family it was unknown, die of the disease 
after cariig for a tubercular husband for eighteen months." 

Sidney, Wm. Mi hoUand, M. D. 

" Mrs. P., a strong woman and of good family, nursed her consumptire husband, 
and in two years died of similar disease. Such ought not to marry." 

Sidney, B. M. Sharp, M. D. 

'• Had one case some three years ago in which a young and healthy wife and mother, 
contracted the disease from her husband, and died in twelve months. The husband 
still living, but a mere shadow." 

Steubenville, Joseph Robertson, M. D. 

" I knew of the wife of a physician who was suffering with consumption who, her- 
self, did not inherit the disease, but it was evidently communicated to her from her 
husband, and she died a short time before he died. I could repeat similar cases." 

Stoulsville, C. A. Kefauver, M- D. 

"Am now treating the wife of a man who died of it. She was always stout and 
healthy with no family history of the disease. She will not live much longer." 

Toledo, Christian Zbinder, M. D. 

" A young man suffered from chronic phthisis, married a healthy girl, they lived a 
few years together, had two children, both died in infancy, then the man died, and a 
few weeks later the wife, of consumption." 

Uhriehsville, W. H. Oviait, M. D. 

" Mr. W. contracted stone cutter's consumption and died. His daughter contracted 
the disease and died, and her husband also contracted consumption and died; lastly, Mrs. 
W., the wife, died of the disease." 

Uhriehsville, J. E. Groves, M. D. 

" Mr. L. died cllf tuberculosis. His wife, in whose family there had never been any 
tuberculosiB, contracted the disease by nursing him, and died two years later." 

Wapakoneta, E. R. Freeman, M. D, 

" I treated a man who died of consumption. In less than a year his child died, and 
in eighteen months his wife, of same disease. No family history of consumption." 

Washington G. H., C. M. Wilson, M. D. 

" Man died after suffering nearly a year with acute tuberculosis. His wife was his 
nurse and constant attendant ; became affected before his death and died in less than a 
year. I know of another case where the husband followed the wife in less than two 
years." 



90 ANNUAL REPORT 

Washington C. H., S. A. Ireland, M. D. 

" Mr. D. had disease for several years, and his wife, thouj^h a healthy woman, no 
eonsumption in her family, died later of same disease. Mr. C. died of consumption, and 
Mrs. C. some two years later." 

West Baltimore, W. I. Christian, M. D. 

" Mrs. W., with no lung trouble, married tubercular husband, and, on taking cold, 
began to eengh, and three months later died of consumption." 

Wwi Sshm, D. N. Garner, M. D. 

" Husbaad nursed by wife, whose previous history was good, in" lees than four 
monthit showed evidence of tuberculosis." 

Wkilehouse, E. Bradley, M. D. 

" I know of cases of perfectly healthy women marrying consumptive men, and 
dying of consumption before the husband. I could recall dozens of cases." 

Wilmington, L. M. Greene, M. D. 

" Was intimately acquainted with a man who died of consumption. At the time 
of his death his family seemed to be in good health. In a few months one son, then 
another, and finally his wife died of the disease. Later a daughter." 

Winchester, C. S. Carboy, M. D. 

" Had a case where man died of tuberculosis, and wife, a healthy woman before, 
died in a year's time of the disease." 

Yov/ngstown, R. H. Montgomery, M. D. 

" Man died of phthisis, and in one year his wife followed, from same disease. No 
heredity." 

Youngsiovm, J. B. Kotheimtr, M. D. 

"Mrs. L. died of consumption. History shows inheritance. Mr. L married again, 
and died of consumption. Second wife died one year after him, having nursed him 
during his illness and contracting the disease. Five children, by first wife, all died of 
consumption." 

DISEASE TRANSMITTED BY WIFE TO HUSBAND. 

Ashland, W. H. Sampsel, M. D. 

" A perfectly healthy and robust husband, without the slightest family history of 
tuberculogis, coatracted the same from his wife, the mother of said wife having died 
from tuberculosis, and the husband succumbing to the disease in thirteen months." 

Arihhold, A. J. Murhach, M. D. 

•' A. L. B., now in the last stages of consumption, came from a family where the 
disease had never existed. He, a healthy and robust man twelve years ago, married, a 
lady coming from a family of which a number had died of consumption. After the 
birth of their second child, the wife developed consumption and died. Shortly after her 
death Mr. B.'s health began to fail, and he is now in the I'ast stages of the disease." 

Barberton, T. Elioit Tail, M. D. 

" I observed a case where the wife died after a lingering illness, and within a year 
the husband died of the same disease." 



OHIO STATE BOARD OF HEALTH. 9 1 

Batavia, Allen A. Ashburn, M. D. 

" One case — woman — age twenty-three years at death, cause, transmitled phthisis. 
Shortly after her death the husband contracted the disease and died. No history of 
tuberculosis on either side of his family, but he was constant in his personal attention 
and care of his wife during the last months of her illness ; sputa was handled on cloths 
or papers by him, and so disposed of by burning," 

JB«aver, A. L. McAllister, M. D. 

"A ca6« communicated from wife to husband. He nursed her until her death." 

Btllavre, P. W. Kerns, M. D. 

•' k lady, school teacher, age 24, married, disease traceable by heredity through four 
jjecerations, died in five months after marriage of consumption. Husband, farmer, age 
25, no heredity of disease in his family, two months after death of wif«, showed symptoms 
and is now in the last stages of the disease." 

Brookvdle, C. Gkh, M. D. 

" An eminent physician's wife died of phthisis and in a year or so he succumbed to 
that disease." 

Bucyrus, W. S. Jackson, M. D, 

"Mr. J., age 50, died last year. Absolutely no family history of any inherited 
disease, but he had nursed his wife, who died two years previous of phthisis." 

Bluffion, F. C. Sleingraver, M. D. 

" A middle aged lady, after lingering a couple of years, died of consumption. Her 
husband, apparently a robust man, married again and in a year or so both he and the 
second wife died of consumption." 

Oampbell, L D. Mareum, M. D. 

'• A neighbor of mine, a healthy man of 30 years, married a consumptive woman. 
He nursed her for about fifteen months and at the expiration of that time he too began 
coughing, and is now about to die of the disease." 

Celina, J. M. Browder, M. D. 

"A wife died, the husband constantly with her; no hereditary history; husband 
died within twelve months after." 

Canton, C. H. Evans, M. D. ^ 

"Mrs. A. married a vigorous and healthy man. She was a consumptive and her 
husband contracted the disease and died two years pior to her death of consumption." 

Cheslerville, B. F. Jackson, M. D. 

" A married lady, consumptive, constantly attende<l by her husband, a healthy, 
rugged man of 35 years. He was constantly in her room for four months, and died of 
the disease within a year after her death." 

Cherry Fork, 0. B. Kirkpatriek, M. D. 

" A man under my care, with good family history, nursed his consumptive wife, and 
now has consumption." 

Cleveland, S. E. Kaestlen, M. D. 

" A. K., age 37, died of consumptioa after two years and a half of suffering. Six 
months after, J. K , husband, age 40 years, always strong, developed same disease and 
died." 



92 ANNUAL REPORT 

Cleveland, E. A. Gatchell, M. D. 

" A strong, healthy man had a wife who died of phthisis; he was with her almcst 
constantly the last year of her Hfe. After her death he began to cough, lost 82 pounds 
of flesh, and had 48 hemorrhages, but he recovered completely." 

Oincinnati, Masaillon Cassat, M. D. 

" A man, 35 years old, who was strong, and whose parents, brothers and sisters were 
strong, had a consumptive wife. He was very fond of her, and after her death contracted 
the disease." 

Circkville, Andrew H. Shaeffer, M. D. 

" A wife having a hereditary diathesis, died of consumption. The husband's family 
had none, but in time he also died of consumption." 

Chicago, D. W. Rumhaugh, M. D. 

" Mr. S., whose family history was good, and who was in excellent health, after nurs- 
ing a consumptive wife, contracted the disease and is passing into a well developed case 
of consumption." 

ChippiVfa Lake, C. W. Hollis, M. D. 

" Mr. B., age 40, and his wife, age 32. Wife was taken sick with tuberculosis and in 
a few months died. The hubband contracted the disease before her death. There was 
no hereditary taint in the parents of the husband." 

Cincinnati, R. G. Longfellow, M. D. 

"A man, who undoubtedly contracted the disease from his wife, who died of general 
tuberculosis, is now under my care." 

Columbus, Norman Gay, M. D. 

" I had a case where the wife was in the last stages of tuberculosis ; the husband, 
apparently well, slept in the same bed with her, and in six months after her death he 
died." 

Columbus, Theodore Jasper, M. D. 

" A friend of mine, of the healthiest stock possible, married a girl whose parents had 
died of consumption. After her first childbed, she developed consumption, and he, 
sharing the same bed with his wife, contracted the disease and died a year and a half 
before the wife." 

Columbus, F. H. Darby, M. D. 

"Mrs. J. died of consumption, attended by her husband, who died not long after of 
the same disease." 

Columbus, Frank Warner, M. D. 

''Mrs. M. was taken ill with consumption, and in six months' time her husband 
was taken down with the same disease. The wife had predisposition, the husband not." 

Custar, H. Mannhardt, M. D. 

" Mr. S., whose family history is exceptionally good, contracted consumption from 
his wife, who inherited the disease (from her father's side)." 

Dovmirngton, J. 0. Clark, M. D. 

"A case, in my opinion, undoubtedly communicated by consumptive wife, who died, 
soon followed by husband, whose father and mother say that there was never any lung 
diseases in their family." 



OHIO STATE BOARD OF HEALTH. 



93 



Farmersville, G. C Henkel, M. D. 

"A husband, whose family was entirely free from tuberculosis, contracted the disease 
from his wife, whose family was not." 

Fayetteville. E. W. Love, M. D. 

" I have lately had two iias^s whert the hu baud in each case died of consumption, 
in my opinion, communicated to them "rom consumptive wives." 

Ftlicity, B. F. Mitchdl, M. D. 

" I was intimately acquainted wiih a couple; ten years after marriage the husband 
died of consumptioo. Two year.s later she married a healthy man who contracted the 
disease and died. She ac;aiD married and in two years the third husband died of con- 
sumption. She fiually ditd of the sjime di^eat-e." 

Findlay, F. W. Enirihin, M. D. 

" Now on hand, a man not predisposed, who will live but a few months ; wife died 
of the disease. He slept with her to the last and has since slowly declined." 

Fort Recovery, Arlington Stephenson, M. D. 

" I treated a lady for consumption and later on the husband and only child, who all 
died. On husband's side no tuberculosis could be traced." 

Gnadenhutlen, B. F. Caen, M- D. 

" I treated Mrs. J. in the last stage of consumption. Her husband was in good 
health, but occupied the same bed and was rather careks? with sputa. In less than 
three years the husband died with the same disease." 

Georgetown, Sidney G. Gordon, M. D. 

''A mother died in '83 or '84, a son in '88 and the father in 1893. Also another son. 
Gross carelessness in regard to sputa." 

German, G. Jamison Mariz, M. D. 

" I treated Mrs. C. for tuberculosis, who died, and am now treating her husband who 
has incipient phthisis." 

Green Camp, D. Free, M. D. 

"One case in which a man, considered extremely healthy, married a woman who 
had consumption. He waited on her for about two years, contracted the disease, and 
died just one day previous to the woman, causing a double funeral." 

Goshen, A. Morris, M. D. 

"A wife died, the disease seeming in her case to be hereditary, and in about a year 
and a half the husband died of the same disease, no case ever having occurred in his 
family before." 

Hanoverton, J. J. Yates, M. D. 

" Mrs. A., a delicate woman, died of consumption ; her husband, an unusually robust 
man, without the least taint of tuberculosis in any branch of his family, died of the same 
disease within eighteen months." 

Haydenville, C. 0. Allen, M. D. 

" Mrs. T. came of a consumptive family, Mr. T. was stout and had no appearance of 
the disease ; four years after marriage she died of the disease, he following within six 
months." 



94 ANNUAL REPORT 

Jersey, J. T. Mills, M. D. 

"Wife in phthisis pulmonalis, aged 22, family history tubercular, died ; husband, 25 
years old, family history good, began to develop pulmonary phthisis and is now a con- 
sumptive. Another similar case." 

Kolida, C. F. Douglass, M. D. 

"Mrs. B., consumptive, possibly hereditary, died in July. Her husband, a stout, 
robust man, with no tendencyto consumptionpriortowife'ssicknesH, contracted the disease 
and died the following spring." 

Loramies, Thomas Walkup, M. D. 

"Mrs. G. had consumption and died, nursed by her husband, who occupies the same 
bed. He took the disease and died." 

Louisville, W. 0. Baker, M. D. 

"A wife took consumption and died in a few years, soon after the husband died of 
the same disesse." 

Louismlle, J. H. Rogers, M. D. 

" Mrs. S. contracted con8ump1,ion and difd. Her husband, a strong, healthy man, 
died the following year, undoubtedly contracting the disease from his wife." 

Moorefield, E. D. Moore, M. D. 

"Mr?. M. developed consumption in April, died in July. Her husband began to 
cough before she died and in less than eighteen months died of the same disease." 

Moxahala, E. L. Ooff, M. D. 

" Mrs. W., aged 30, had consumption for five years. Mr. W., a very robust man, 
began to complain some three or four months prior to his wife's death, and in about six 
M»nths died of the disease. Could give a dozen such cases." 

Mt. Vernon, S. D. Spees, M. D. 

"Treated a lady the last week of her illness, duration four years, and the husband, 
having no predisposition to the disease, began to cough and rapidly declined. The 
disease undoubtedly being contracted from wife." 

New Burlington, Chas. S. Estep, M. D. 

"Mr. H., stout, robust man, waited on his wife for five months, when she died. He 
went down to a walking skeleton with all signs of consumption, but regained a fair de- 
gree of health in a few years." 

New Philadelphia, J. F. Maclean, M. D. 

" Have known a case of suspected consumption in a husband whose wife died with 
the disease. Also had a husband die with consumption who had a good family history 
but had been married to a chronic consumptive for about eighteen months. Wife died 
about two years later. The husband was strong and well when married." 

Nimisila, Adam Sisler, M. D. 

"A young couple came here and within a year the wife died of consumption. In 
about a year later the husband died of the same disease. No consumption in his family. 

North Georgetown, J. M. Earnst, M. D. 

" Mr. B. nursed and took care of his wife who died of consumption, and in less than 
three years he took it and died. No consumption in his family." 



OHIO STATE BOARD OF HEALTH. 95 

Nottingham, W. 0. Jenks, M. D. 

"I treated a married woman who died of consumption. Her husband married 
again in less than a year and in six months after died of the disease. The next 
year the second wife died of consumption." 

Chcford, G. 0. Munns^, M. D. 

" A. B,, strong, healthy, without history of consumption in his family, married a 
consumptive girl who died soon after. The husband developed consumption and died." 

Richmondale, Thos. TF. Evans, M. D. 

"A husband, family history free from the disease, contracted consumption from his 
wife. The wife died, and in five months the husband was taken down and died in about 
eight months after his wife." 

Swan, W. R. Moore, M. D. 

"The disease was developed in a strong, healthy man, without any hereditary taint, 
about six months after the death of his wife whom he nursed and carefully watched for 
a year prior to her death from consumption." 

Selina, T. C. Edginglon, M. D. 

"A young man, twice married and both women dying of consumption, having no 
predisposition as to heredity, died one year after the death of his last wife." 

Spencer, Wm. H. Siroup, M. D. 

"A lady died of consumption. Husband began to cough, and I believe will die of 
consumption. No consumption in his family." 

Trenton, H. Schainfeld, M. D. 

"Mrs. H., after her last babe was born, contracted lung trouble, going from bad to 
worse until death claimed her. Mr. H., healthy man, shared her bed all the time and 
began to cough, and within a very short time shared the lot of his wife." 

Uhrichsville, W. H. Oviatt, M. D. 

" Daughter of a consumptive contracted same and died, and her husband soon after 
died of same disease." 

Van Wert, J. Arthur Hines, Jf. D. 

"G. R., whose wife died of pulmonary phthisis, healthy parentage, German, age 
thirty-five, ' never sick in his life,' acquired the disease and died." 

Versailles, J. E. Fackler, M. D. 

" A young man married a woman of consumptive family. She died, and in a few 
years consumption developed and he also died. No consumption in his family." 

West Cleveland, Nellie C. Mtsier, M. D. 

" A case where wife died of consumption, and I hardly think the husband will live 
two months. He knows of no consumption in his family." 

West Mansfield, J. J. Bcwker, M. D. 

" A case where husband slept with consumptive wife." 

West Middleburg, C. C. Stokes, M. D. 

" One case where wife, after a long period of tuberculosis, died. The husband was 
very attentive, and in a few months manifested the same disease and died." 



96 ANNUAL REPORT 

Williamsporl, T. C. Tipton, M. D. 

"A man died of consumption af er nursing his wife who died of the disease." 

Wihon, J. W. McGloughlin, M. D. 

" A man married a consumptive woman and in two years contracted a hollow con- 
sumptive cough. 8he died and he is weak-lunged. No consumptive taint in his family." 

Yellow Si>rinfjs, W. M. Haffaer, M. D. 

"A wife had consumption. The husband contracted the disease by sleeping in the 
same room with her. She died, and a year or so after he also died. He had no 
family taint." 

Tounf/siov-n, J. B Kotheimer, M. D. 

' Mrs. L. died of consumption. History shows inhtritauce. Mr. L. died later of 
the same disease." 

Zanesville, A. L. Jackson, M. D. 

"I treated a lady who died of consumption. Her husband, against my orders, occu- 
pied the same bed, and although strong and healthy and only thirty years old, in less 
than a year died of the same disease." 

DISEASE TRANSMITTED BY HUSBAND TO WIFE, OB WIFE TO HUSBAND. 

Akron, James P. Boyd, M. D. 

"Hare seen many instances where wife has seemed to contract it from husband, or 
vice versa." j^^ 

Alliance, H. H. Shafer, M. D. 

"I have seen where wife gave it to husband, and where husband gave it to wife. 
These are facts in my opinion." 

Ashland, P. H. Clark, M. D. 

"I could give many instances. From sleeping in the same bed and taking the 
general care of the sick, especially of the wife taking the entire charge of the husband, 
or vice versa. 

Ashley, M. M. Scheble, M. D. 

"I have known consumption to be communicated from a man to his wife and 
vice versa." 

Bowling Green, W. M. Tuller, M. D. 

"Several cases where the husband and wife, who had no hereditary history, have 
contracted the disease from the other." 

Bluffton, I. R. Wetherill, M. D. 

"I have often observed where the wife or husband slept in the same room and no 
precautions were taken, that both in time became afiected." 

Canal Winchester, L. W. Beery, M. D. 

" Have had a few cases in which the husband and wife died of consumption, and in 
which I was led to believe that one communicated the disease to the other." 

Cincinnati, E. W. Ludlow, M. D. 

"Two cases. Wife gives history, several having had the disease in her family; 
husband gives negative history. Disease further advanced in husband." 



OHIO STATE BOARD OF HEALTH. 97 

Chicago, E. V. B. Buckingham, M. D. 

"I have treated several cases where either the husband or wife died of consumption, 
the other having no hereditary taint, yet, within a short time after the death of the one 
the other died of the same disease." 

Cleves, Edward F. Davis, M, D. 

"I have known of three cases where one patient w«uld die of consumption and the 
other would contract the disease, and in one case the children also." 

Cleveland, A. F. Green, M. D. 

"Husband and wife, one well and strong, nursed and slept with the other suffering 
from consumption, and died of the same disease in a few months." 

Dayton, A. H. Iddings, M. D. 

"Strong indications of the disease having been communicated from husband to wife 
and vice versa." 

Defiance, D. P. Aldrich, M. D. 

"I have seen many cases where husband or wife in caring for the other took con- 
sumption, where there was no taint of consumption in their family history." 

East Liberty, E. B. Smith, M. D. 

"I have had several cases where husband and wife have both died with consumption, 
one or two years apart, where no taint of the same could be traced on one sde." 

Frankfort, T. E. Griffiths, M. D. 

"Where husbands and wives have slept together, where proper care of the sputa was 
not taken." 

Huron, Joseph P. Esch, M. D. 

"I have known several cases where both husband and wife died with consumption, 
where I was perfectly satisfied that one contracted the disease from the other." 

Lancaster, G. A. Harman, M. D. 

"I have known the wife to follow the husband, and vice versa, where the other did 
not seem to have any heredity." 

Laurelville, W. H Samson, M. D. 

"I know of two or three families where the wife died of pulmoDary consumption 
and now the husband is in the last stage of same disease." 

Magnetic Springs, H. McFadden, M. jD. 

"I have known of several cases contracted by intermarriage of families where there 
was consumption on one side and none on the other, where both husband and wife died 
of the disease, the one on the consumptive sicie being nursed by the other." 

Marietta, C. W. Eddy, M. D. 

"In two or three instances I have known either husband or wife contracting phthisis, 
who had no history of lung trouble in the family." 

Mt. Vernon, F. C. Larrimore, M. D. 

"Several marked cases where the disease was communicated by husband to wife, or 
vice versa." 

7 ST. B. H. 



98 ANNUAL REPORT 

Newark, B. F. Spencer, M. D. 

''A man, well formed and of exceptionally good family, married a woman who died 
of pulmonary consumption. He married again and his second wife died of the same 
disease. He also died of well marked pulmonary consumption." 

New Castle, J. W. Snider, M. D. 

"I have seen several cases of apparent contraction of the disease by tleeping with, 
and waiting on, diseased husband or wife." 

Neviark, H. R. Burner, M. D. 

"I have known numerous cases where the disease seemed to be transmitted from 
husband to wife and from wife to husband. More frequently, I think, from husband to 

wife." 

Nev) Lexington, J. G. McDour/al, M. D. 

"I have several instances in mind where the husband or wife died of consumption, 
and the other, with no history unfavorable, has contracted the disease." 

Owensville, T. A. Mitchell, M. D. 

"Two instances where tubercular persons were wedded to perfectly healthy persons. 
The tubercular person dying, in each case, within two years, and soon after the other 
died of the disease." 

Paulding, P. A. Dix, M. D. 

"I have known cases where I was satisfied that either the husband or the wife com- 
municated the disease to the other, and both died in a short time, where one had been 
healthy previous to marriage." 

Springfield, T. M. Reade, M. D. 

"The only cases of contagion I have observed were those of wives whose husbands 
died of consumption. Probably a dozen cases in as many years." 

Tranquility, E. M. Gaston, M. D. 

"In several instances where husband or wife died with consumption, after waiting 
upon companion sufTeriEg from the disease, having no history of their own 
hereditary trouble. In two cases where the fathers died of the disease, while they were 
sick four children in one family and three in the other died of tuberculosis, and after 
the father's death the wife, as well as the remaining children, showed strong marks of the 
disease, but were ultimately able to throw it off." 

Toledo, James Donnelly, M. D. 

"I know of a few cases in which the husband had phthisis and later the wife was 
stricken down with the same disease." 

Winona, A. LeCope, M. D. 

"I have known a case or two where the husband died with consumption and after- 
wards the wife, who cared for him, slept with and nursed him." 

The following circular on the Prevention of Consumption was adopted 
at the April meeting of the Board, and 100,000 copies were printed : 



OHIO STATE BOARD OF HEALTH. 99 

THE PREVENTION OF CONSUMPTION. 

ISSUED BY THE 

OHIO STATE BOARD OF HEALTH. 
1894. 

Consumption, or pulmonary tuberculosis, is now known to be a communicable, that 
is, a contagious disease. 

It is caused by the growth in the body of a microscopic plant or germ which sets 
up inflammatory conditions of the lungs causing fever, wasting and death in many 
cases within two or three years. The germ causes the growth in the lungs of little 
masses known as tubercles, and as the disease progresses these soften and break down 
and are expectorated by the patient. The expectoration contains millions of these 
minute plant bodies which, when the expectorated matter has dried, are set free and are 
blown about here and there by the winds or air currents of houses. They are taken 
into the lungs of some other person by breathing, and if they find a soil suitable for 
their growth, again produce the disease. If we could but destroy all these germs which 
are the sole exciting cause of the disease, consumption could be completely stamped out. 

We should thoroughly realize that consumption is comm,unicable and therefore 
preventable. 

The gravity of the disease should also be appreciated. Ceaselessly, during every 
hour of time, by night and by day, fourteen persons die of consumption in the United 
States alone ; and about one-seventh of all who die among civilized races die of tuber- 
culosis of some form. 

We have become for this disease like men in battle who see their companions drop- 
ping from the ranks with almost fatalistic indifference. An every day occurrence soon 
becomes unnoted. 

Consumption is preventable. This should be the cry all over the land. 

The exciting cause, as already stated, is positively known to be the germ, called the 
bacillus tuberculosis, and without it the disease could not occur ; but there are many pre- 
disposing or helping causes which enter into the production of consumption, and these 
must not be neglected. The germs are the seeds, but like all other seeds they must have 
a suitable soil in which to grow. 

For many years it was held that consumption was inherited. Believing this, it was 
but natural that we should fold our hands and allow the consumptive-tainted to die. 
We know now that the disease isnot transmitted by inheritance — the germ does not pass 
from father or mother to the ofl'spring. Undoubtedly, however, a marked tendency to 
contract the disease when exposed to the exciting cause — the germ — is an inheritance from 
consumptive parents, and every possible precaution should be taken by such persons to 
avoid this exciting cause, and to increase bodily resistance to the disease. 

Consumption is largely a disease of civilization, due to living in close, poorly ven- 
tilated houses and cities, amid other unhealthful surroundings. 

Certain occupations also tend to produce it, and especially occupations where there 
is constant breathing of foul air filled with irritating dusts. 

Damp soil and damp houses, and all the unsanitary canditions which produce low 
ered health, act as predisposing causes. 



lOO ANNUAL REPORT 



HOW PREVENTED. 



Let us first consider the destruction of the germ — the exciting cause. 

This we find principally in the matter expectorated by consumptives. The germ 
is never in the breath of the patient, nor in the exhalations or excretions from the body, 
except when the bowels have become affected, when it may be found in the stools. 

There is no danger then in associating with a consumptive, nor allowing him to go 
abroad, if we destroy the germs contained only in the expectoration; and the expecto- 
ration only becomes dangerous after it has dried and the germs are liberated. 

The germs qaay be destroyed by burning the expectorated matter, or by casting it 
into a solution containing a disinfectant strong enough to kill them. When handker- 
chiefs or cloths are used, or when the patient expectorates on the floor, or into a dry 
cuspidor, the germs become free, by drying, and are blown about the room, settling upon 
the floor, furniture, window ledges, walls, etc. Such a room is dangerous, and especi- 
ally so if poorly ventilated, to any person predisposed to the disease. 

It has been positively proven that these dried germs will remain alive and active 
for the production of the disease for several months. 

With very careless, or very ill and feeble patients, the clothing and bedding may 
become soiled with expectorated matter, and become a source of danger to others. 

Consumptive patients on the streets frequently, perhaps usually, expectorate on the 
ground or pavement, and the germs becoming dried may be blown hither and thither, 
endangering possibly the lives of hundreds. 

In various other ways a person afflicted with consumption, through ignorance or a 
criminal disregard for others, may sow the seeds of death broadcast. 

Consumption in its earlier stages is, in many instances, curable as well as prevent- 
able, but the chances of recovery are greatly reduced by living in an atmosphere highly 
infected by the germs of the disease, as the patient may reinfect himself. It is of the 
greatest importance to the patient, therefore, as well as to those around him, that his in- 
fectious expectorations should be promptly destroyed. 

While consumption, or pulmonary tuberculosis, is the most common form of tuber- 
culosis, the germ may grow in other parts of the body. Tuberculosis of the bowels is of 
frequent occurrence, especially in children, and is usually produc d by eating meat or 
drinking milk from an animal afiected with the disease. Tuberculosis prevails among 
animals, especially milch cows, to an unknown but very great extent, so that the danger 
from this source is considerable; and health authorities should be cordially supported 
in every possible effort to prevent the sale of infected animal products. 

With these general remarks concerning the cause and manner of production of 
consumption, we may proceed to consider specific 

RULES FOR PREVENTION. 

1. In the house the expectorations of a consumptive patient should be received on 
bits of old cloth or Japanese paper and be burned at once, or received in cuspidors or 
Bpit-cups containing a solution of 

Corrosive sublimate 1 drachm 

Hydrochloric acid 2 ounces Label poison. 

Water , 1 gallon 

2. The clothing and bedding of the patient should be laundried separately, and 
thoroughly boiled. 

3. Sweeping should be done with a dampened broom, or with wet tea leaves or 
sawdust on the floor, and the dust removed from the furniture, etc., with a cloth wet 
with the disinfectant solution. 

4. Dishes, glasses, cutlery, etc., used by the patient should be scalded before being 
used again. 



OHIO STATE BOARD OF HEALTH. IQI 

5. It is better for the patient and safer for others that he sleep in a room alone, 
and especially in a bed to himself. 

6. The disease may be transmitted by kissing, especially kissing upon the mouth. 

7. Admit an abundance of pure air and sunlight to the patient's room. 

8. If the house is damp use proper means to secure dry foundation walls and 
basement. 

9. On the street the patient should either use an expectoration flask (many such 
are made) or cloths or papers, to be burned as soon as possible. If a handkerchief must 
be used, place it in boiling water or in a disinfectant solution before the expectoration 
can dry. 

TO AVOID CONSUMPTION. 

1. Eat meat cooked well done, as this will destroy the germ. Boiling will destroy 
the germs in milk, and young children who are especially prone to tuberculosis of the 
bowels, should be given only boiled milk. 

2. A mother with consumption should not suckle her child, as she may infect it 
through her milk. 

3. Do not move into a house, or sleep in a room in which a person has died of or 
been sick with consumption, until it has been properly disinfected. 

4. Avoid as far as possible occupying for any length of time with a consumptive 
person, a badly ventilated room, car or vessel. 

5. If a tendency to the disease has been inherited, be specially guarded against all 
sources of infection. In addition select an outdoor occupation as free as possible from 
dust; use every means to secure a good physical development, particularly of the chest 
and lungs; select a dry soil for a habitation, and have living and sleeping rooms freely 
ventilated and well exposed to direct sunlight. 

6. In selecting a mate in marriage choose one free from any inherited scrofulous or 
tubercular taint. 

"VVe trust all persons reading this circular will aid in disseminating the information 
it contains. It is only by arousing the public to a realizing sense of the fact that 
consumption is communicable and preventable that we may hope to stay the ravages of this 
disease, which alone slays more than all the other contagious diseases combined. 
Copies of this circular will be sent free to any person applying to the 

Secretary of the State Board of Health, 

Columbus, Ohio. 

The circular on the Prevention of Consumption has gained entrance 
to thousands of homes containing victims of this disease, and we may 
confidently expect that the greater precautions against contagion which 
will be taken as a consequence will be the means of saving many persons 
from the disease. 

Another result of this "educational crusade" to be hoped for, is that 
enlightened public opinion will soon enable health authorities to adopt 
more stringent measures for the prevention of this, the greatest plague of 
mankind. 

The circular letters which follow sufficiently indicate the methods 
adopted to disseminate among the people correct information in regard to 
the causation and prevention of consumption. 



102 ANNUAL REPORT 

Ohio State Board of Health, 
Office of the Secretary, Columbus, O., May 1, 1894. 

Dear Doctor : Answers have been received from a considerable number of the 
physicians of Ohio in regard to our inquiry concerning tuberculosis and its prevention. 

It is gratifying to note that with practically no exceptions the members of the pro- 
fession have expressed a willingness to co-operate with the Board in an eflfort to lessen 
the spread of this disease. 

Some exceedingly interesting matter has been collected showing the contagious char- 
acter of tubereulosis, which will be published in the near future, and a copy of the re- 
port sent to you. 

It has been decided, for the present, not to require physicians to report cases of tuber- 
culesis, as it is believed that the public is not sufficiently well informed as to the con- 
tagious character of the disease. Every effort will be made to spread among the people 
the knowledge that consumption is a communicable disease and therefore preventable, and 
to this end dependence must largely be placed upon members of the medical profession^ 

Enclosed herewith are copies of a circular adopted by the Board on " The Prevention 
of Consumption, " and you are requested, if the circular meets with your approval, to 
place a copy in the hands of each family where you are called on account of tubercu- 
losis, and to urge compliance with its directions. As many additional copies as you de- 
sire will be sent on application. 

The local authorities will be instructed to have proper measures of inspection 
carried out in all cases where death occurs from pulmonary tuberculosis, and we trust 
you will aid in having this measure enforced. 

Respectfully, 

C. 0. Probst, M. D., Secretary. 

Ohio State Board of Health, 
Office of the Secretary, Columbus, O., May 8, 1894. 

To the Editor : 

Dear Sir: I send you enclosed a circular just issued by the State Board of Health 
on "The Prevention of Consumption, " and earnestly request your assistance in making 
public the information it contains. 

There is no longer a doubt as to the contagiousness of consumption, nor that the 
disease may, to a large extent, be prevented. For many reasons it is impracticable, if 
not undesirable, to treat consumptive patients as we do those afflicted with diphtheria, 
small-pox or contagious diseases of that class. A consumptive is not dangerous to others 
with proper care, and at present we must depend on an educational campaign. 

More deaths occur from consumption each year in Ohio than from all the other 
contagious diseases combined ; and with your help we hope to impress the general public 
with the fact that this great annual slaughter can be very materially lessened. 

I shall be greatly obliged if you will kindly send me a copy of what you publish on 
this subject. 

Respectfully, 

C. O. Probst, M. D., Secretary. 

Ohio State Board of Health, 

Office of the Secretary,* Columbus, O., May, 1894. 

To the Superintendent of Schools : 

Dear Sir : The State Board of Health has determined to commence a crusade 
against consumption. It has been decided that for the present this must be largely a 
matter of education. A circular on "The Prevention of Consumption," enclosed 
herewith, was prepared for popular instruction. 



OHIO STATE BOARD OF HEALTH. IO3 

The physicians of Ohio have agreed to place copies of this circular in all families 
where they are called on account of consumption. The circular will also be printed by 
a large number of our newspapers ; and we hope to enlist your aid in spreading the in- 
formation this circular contains. 

There is no longer a doubt that consumption may be communicated from one person 
to another. Hundreds of such cases have been reported to us by the physicians of Ohio. 
It is also true that this may be often prevented by measures easily enforced. 

We desire to know whether you think it would be advisable to impart such informa- 
tion to advanced pupils under your charge. It would doubtless be ill-advised to excite 
unnecessary alarm, and especially to too seriously impress children with the danger of 
associating with a consumptive person. But would it not be well that every pupil leav- 
ing school should realize that one-seventh of all who die' are victims to a disease which 
in many cases might be prevented? That this disease may be communicated by the sick 
to the well, but that this may be prevented by comparatively simple measures? 

Let our people fully realize the dangers that encompass them, and how these dan- 
gers may be averted, and we may confidently expect that the law of self-preservation 
will work out the remedy. 

Additional copies of the circular on Prevention of Consumption will be sent you if 
desired. 

Respectfully, 

C. O. Probst, M. D , Secretary. 

Ohio State Board of Health, 
Office of the Secretary, Columbus, O., June 6, 1894. 
To Local Boards of Health : 

We invite your attention to the circulars enclosed herewith on the Prevention of 
Consumption. 

Copies of this circular have been sent to all physicians in the State, with the request 
that they be placed in families to which they are called on account of consumption. 

Your attention is specially directed to the necessity of disinfecting rooms which 
have been occupied by persons sufl'ering from consumption. Boards of health should 
offer to disinfect, free of charge, any house in which a case of consumption has occurred. 
Physicians have been requested to report to the board of health, for disinfection, all 
houses in which consumption occurs, and which have not been properly disinfected by 
the family. 

It has been deemed advisable, for the present, to depend on the family physician for 
placing the circular on the Prevention of Consumption in families where the disease 
exists. Additional copies will be furnished to boards of health, on request, for such 
other distribution as they deem adv;8able. 

Now, that it has been established that consumption is a communicable, and therefore 9, 
•preventable disease, there should be a combined effort on the part of health authorities 
and the medical profession to stay the ravages of this great pleague. We bespeak your 
cordial assistance. 

Yours truly, 

C. O. Probst, M. D., Secretary. 



104 ANNUAL REPORT 



SMALL-POX AND VACCINATION. 

BY THE SECRETARY. 

The past year has witnessed more than the usual prevalence of small- 
pox, not only in Ohio, but in a large number of the United States. In 
Chicago, Brooklyn and Milwaukee, the disease assumed epidemic propor- 
tions, and health authorities throughout the country were alarmed at the 
outlook. In our own State there was good cause for alarm, considering 
the many independent centers of infection existing at one time, and the 
large number of people unprotected by a previous attack of small-pox or 
by vaccination. A general epidemic was only averted by the prompt ac- 
tion of the State and local authorities in enforcing proper measures. 

About the close of the year 1893, small-pox was reported in Colum- 
bus ; it then broke out in Springfield, and chronologically, in the order 
named, appeared in the following places, viz. : Shelby, Toledo, Lima, 
Worthington, Vinton, Lorain, Cleveland, Collin wood and Luckey. The 
disease was repeatedly introduced into Columbus, Cleveland and Toledo, 
but did not spread to any great extent. 

During January of 1894, numerous reports of outbreaks in other 
States were received. The news from Chicago was far from assuring. 
The secretary of the Illinois State Board of Health, in answer to an in- 
quiry, stated in a letter of the 17th of January, " I am not able to give 
you reliable information as to the extent of the disease in Chicago since 
my last report. Enough is known to warrant me in asserting that the 
disease is increasing rapidly in the city, new centers of infection being 
frequently discovered." 

Early in February the following circular letter was sent to the gen- 
eral managers and superintendents of all railroads operated in whole or 
in part in Ohio : 

Ohio State Board of Health, 
Secretary's Office, Columbus, O., February 5, 1894. 
To General Managers and Superintendents of Railroads: 

Dear Sirs : I beg leave to call your attention to the wide prevalence of small-pox 
in the United States at this time, and to suggest the desirability of requiring vaccinna- 
tion of all railway employes, but especially trainmen, freight handlers, car cleaners, etc. 

Within the past two months small-pox has been reported in the following States : 
Massachusetts, New York, Connecticut, Pennsylvania, West Virginia, Ohio, Kentucky, 
Tennessee, Virginia, Michigan, Illinois, Minnesota, Wisconsin, North Carolina, Indiana 
and Louisiana. 

In Chicago small- pox prevails to an alarming extent, and has recently been carried 
from that city to Springfield, Ohio. With small-pox so widely prevalent there is con- 
siderable danger of railway employes coming in contact with the disease. A case in 



OHIO STATE BOARD OF HEALTH. IO5 

point has just occurred. On the 25th of last month a woman, broken out with small- 
pox at the time, traveled by train from Cleveland to Vernon Station, Ohio, exposing 
passengers and trainmen to the disease. Other recent cases point to this danger. 

A coach cleaner developed small-pox in Chattanooga, Tenn., November 7, 1893. A 
week or two later a Pii/Zmaji porter came down with small -pox at Nashville, and about 
the same time a case developed in a person in Louisville, Ky., who worked in a laundry 
where the eft'ects of Pullman cars are washed. 

Vaccination and revaccination of railroad employes would at all times, we be- 
lieve, be of advantage to railroad companies as well as a safeguard to the traveling pub- 
lic ; but the necessity for this measure may be specially urged at the present time, when 
small-pox is so widely scattered over the United States. 

If action to this end is taken by your company we should be pleased to know of it. 
Very respectfully, 

C. O. Probst, M. D., Secretary. 

Railway authorities responded very promptly, and within a short 
time most of their employes were vaccinated. 

Reports of outbreaks of small-pox in other states showed that in 
numerous instances the disease was introduced by tramps. Several such 
cases occurred in Ohio. From England, also, where small-pox v^as widely 
prevalent at this time, came reports that the tramp was responsible for a 
considerable number of their outbreaks. At Bradford, England, where 
several hundred cases occurred, the disease was introduced by a tramp. 
Hoping to stop, or lessen, this source of danger the local boards of health 
were communicated with as follows : 

Ohio State Board op Health, 
Secretary's Office, Columbus, O., February 28, 1894. 

To the Board of Health : 

Gentlemen : Your attention is again called to the prevalence cf small-pox in the 
United States, and to the recent outbreaks in Ohio. 

Within the past month, cases have been reported in our State as follows: Spring- 
field, 1 case ; Toledo, 4 cases ; Lima, 1 case; Dayton, 1 suspected case, not yet fully de- 
termined ; Columbus, 1 case. 

Small-pox has recently been introduced into a number of places by tramps. There 
are a large number of these lodged nightly in our prisons and jails, and there is con- 
siderable danger of the disease being spread in this manner. 

It is recommended that your board, co-operating with the council and police, re- 
quire that each tramp given a night's lodging shall first be examined by a physician 
to insure that he is not suffering from a contagious disease, and especially from symp- 
toms suspicious of small-pox; and also that you require him to be vaccinated. If this rule 
is enforced by all our cities and villages the danger from this source will be greatly 
diminished. 

Two, and possibly three, of the recent outbreaks in Ohio have been traced to Chi- 
cago, and this experience has been repeated in other states ; so that special attention 
should be paid to tramps from that city. 

Please telegraph me at once should a case of small-pox occur within your juris- 
diction. 



I06 ANNUAL REPORT 

We have constantly on hand a small supply of pure, fresh vaccine virus, which 
will be sent immediately on the report of small-pox, to be used in vaccinating persons 
who have actually been exposed to the disease. 

Respectfully, 

C. O. Probst, M. D., Secretary. 

Subsequently the Indiana State Board of Health carried this matter 
even further and issued a mandatory order to local authorities to vacci- 
nate all tramps. There may be some doubt as to the authority to en- 
force compulsory vaccination of tramps ; but as most of them in cold 
weather present themselves to the authorities for night lodgings, grant- 
ing this might be made conditional on submitting to vaccination. If 
such a measure could be enforced in all states the danger from tramps as 
carriers of small-pox would be greatly lessened. 

Several of the outbreaks of small-pox in Ohio were traceable to Chi- 
cago. This was also true as regards other states, as shown by their re- 
ports. 

A meeting of the secretaries of the State Boards of Health of Illinois, 
Indiana and Ohio was held in Chicago in February, the health commis- 
sioner of Chicago being present. The commissioner made a report of 
the number of cases of small-pox in the city, and the means employed 
to prevent spread of the disease. These were not altogether satisfactory, 
and there was reason to fear that Ohio, with her many railroad connec- 
tions with Chicago, was in some danger from that point. During April 
and the first part of May, small-pox continuing to increase rapidly in 
Chicago, it was considered advisable to call together representatives of 
State Boards of Health of states specially endangered by the epidemic. 
The meeting was held in Chicago May 9 and 10, 1894, and the following 
abstract of the proceedings will be found of special interest as dealing 
with the problem of contagious diseases in '' sweat-shops, " and the dan- 
ger Irom clothing made in such places : 

ABSTRACT OF PROCEEDINGS OF A CONFERENCE OF REPRE- 
SENTATIVES OF STATE BOARDS OF HEALTH OF 

ILLINOIS, INDIANA, WISCONSIN, MICHIGAN AND OHIO, AND OF THE U. S. 

MARINE HOSPITAL SERVICE AND HEALTH COMMISSIONER 

OF CHICAGO. 



Representatives of the State Boards of Health of Illinois, Indiana, 
Wisconsin, Michigan, Minnesota, Iowa, Missouri, Kentucky, Ohio, the 
Province of Ontario, and the Marine Hospital Service, were requested to 
meet in Chicago, at the Grand Pacific Hotel, Wednesday evening, May 9, 



OHIO STATE BOARD OF HEALTH. IO7 

for the purpose of considering the small-pox situation in the United 
States, but more especially in Chicago, as affecting their respective states. 
The call was issued by Dr. Probst, of Ohio, as Secretary of the National 
Conference of State Boards of Health. The following representatives were 
present : 

Illinois Dr. J. W. Scott. 

Indiana Dr. C. M. Metcalf. 

Indiana Dr. L. L. Whitesides. 

Indiana Dr. D. C. Kamsey. 

Michigan Dr. Henry B.Baker. 

Wisconsin .' Dr. J. T. Reeve. 

Ohio Dr. C. O. Probst. 

M. H. S Dr. J. H. Hamilton. 

Dr. F. W. Reilly, ex-secretary of the Illinois State Board of Health 
was present by invitation. Dr. Scott was chosen for chairman and Dr. 
Probst for secretary. 

Dr. Scott stated that Dr. Reynolds, health commissioner of Chicago, 
had been invited to be present, but was unable to be there. 

At the request of Dr. Baker, Dr. Scott made a statement as to the 
small-pox situation in Chicago. He stated that there had been 1,417 cases 
of small pox in Chicago from January 1 to May 9, inclusive. By months 
the cases occurred as follows : 

January, 128 cases. Daily average 41. 
February, 233 cases. Daily average 8.3. 
March, 305 cases. Daily average 9.8. 
April, 544 cases. Daily average 16.1. 
May 1 to 9, 207 cases. Daily average 23.2. 

He said the disease was now prevailing to a considerable extent 
among the tenement house population, where domiciliary quarantine 
could not be properly enforced. 

Dr. Probst stated that an inspection of one of the infected districts — 
one in which many sweat-shops were located — was made by Drs. Metcalf, 
Ramsey, Scott and himself during the afternoon of the 9th, and that 
apparently the only measure for quarantining infected houses was placard- 
ing. Many cases of small-pox were visited without hindrance. In one 
instance a house, containing eleven families and four cases of small-pox, 
was entered under the eyes of the police. No restriction was placed on 
the inmates. There was evidently great danger of infection from cloth- 
ing made in sweat-shops in this and other small-pox districts. 

Dr. Hamilton stated that all vessels leaving Chicago were inspected 
by officers of the Marine Hospital Service, and vaccinal protection of crews 
and passengers required. ^ 



I08 ANNUAL REPORT 

Dr. Probst recommended a daily inspection of all persons living oi 
working in houses containing "sweat-shops" where clothing is made or 
finished, such inspection to be made by medical inspectors under the 
supervision of the Illinois State Board of Health, and suggested that the 
wholesale clothiers of Chicago would b6 willing to bear the necessary 
expense. 

It was decided to invite representatives of Chicago manufacturers of 
clothing to meet the Conference at 2 p. m. of the following day to consider 
measures to prevent spread of small-pox by means of clothing made 
in "sweat-shops." 

A committee was appointed to invite the health commissioner of 
Chicago to attend the meeting. 

Drs. Hamilton, Baker and Ramsey were appointed to draft a plan for 
protection against small-pox from sweat-shop clothing, to be presented, 
after adoption by the Conference, at the meeting with Chicago clothiers. 
Also to present plans for quarantine, if this should be deemed advisable^ 

Drs. Probst, Scott and Reeve were appointed to formulate plans for 
the proper management of small-pox epidemics in large cities. 

At a meeting of the Conference held at 10 a. m. on the iOth May, the 
following resolutions and reports were handed in by the committee pre- 
viously named, and were unanimously adopted : 

Resolved, That this Conference respectfully inform manufacturers of textiles, that 
owing to the prevalence of small-pox in certain districts of this city, deep apprehension 
exists in regard to the possible infection of clothing made or finished by persons or 
families living in the said districts, some of whom are in close relation with the sick, 
either in the same house, or having free communication therewith ; 

That in view of these facts, we further inform the said manufacturers that under 
the circumstances, as above set forth, we shall be obliged to recommend to our several 
State Boards of Health that no clothing or ladies' dresses for sale be allowed to enter, or 
be distributed within our respective States, except in accordance with the following 
measures : 

That an efficient daily inspection, with all that such inspection implies, of all places 
in which such goods are manufactured in the city of Chicago, be established and main- 
tained under the direct supervision of the Illinois State Board of Health, to the end that 
no such articles from any infected locality shall be put upon the market for sale, or 
shipment, or be otherwise distributed to the menace of the public health. 

'1 he adoption of the foregoing measures will, in our opinion, measur- 
ably restore confidence, and facilitate trade, but we desire to point out 
that the continuance of trade will finally depend on efficient general 
sanitary operations for the suppression of the disease. 

Resolved, That in the opinion of this Conference, strict quarantine by land is at 
present unnecessary, but the question may well be considered now whether persons from 
any city where small-pox exists in epidemic form should be allowed to stop in our States 
without having a certificate of vaccination within the past three years; and that, in 



OHIO STATE BOARD OF HEALTH. IO9 

case of establishment of quarantine, all passengers boarding trains should be informed, 
that unless provided with vaccination certificates from proper authorities they will be 
liable to examination and vaccination at the State line. Be it further 

Resolved, That no vessel plying on the lakes should be allowed to enter any port 
within the boundaries of our respective States without having on board, subject to 
inspection, a Bill of Health, duly signed by an officer of the United States Marine 
Hospital Service. 

The following recommendations for dealing with an epidemic out- 
break of small-pox in large cities were adopted : 

1. The city should be divided into districts containing not more than 10,000 people. 

2. Each district should be placed under the supervision of a competent medical 
inspector with necessary assistants to 

(a.) Make a house to house inspection. 

(6.) To successfully vaccinate within the shortest possible time all persons who 
have not been vaccinated during the outbreak, the first vaccination to be within seven 
days. 

(c.) To properly disinfect all houses and their contents where small-pox occurs. 

3. Necessary means and appliances for efficient disinfection of materials, premises, 
etc., should be provided as the exigencies of each district may require. 

4. Each case of small-pox should be immediately removed to a suitably constructed 
and properly equipped and officered isolation hospital. 

5. Except in extreme cold weather, hospital tents, as prescribed in the United 
States Army regulations, floored and warmed, are preferable to the average hospital or 
private dwelling, and increase the chances for recovery of the patient. 

6. Cases of small-pox necessarily detained in their own homes should, with their 
attendants, be rigidly isolated during the period of danger; and physicians visiting such 
patients professionally shall be subject to such regulations as may be prescribed by the 
local tiealth officer. 

7. Persons exposed to small-pox contagion should be immediately vaccinated, or 
re-vaccinated, and kept under observation for not less than fourteen days from the time 
of last exposure. 

8. It is the sense of this Conference that it will be necessary for neighboring cities 
and states to exclude all persons who come from such city, who are not protected against 
small-pox by vaccination, and to require proper disinfection of all baggage and 
merchandise capable of conveying small-pox infection, unless such measures are 
enforced. 



CONFERENCE OF REPRESENTATIVES OF STATE B0ARD3 OF HEALTH AND OF 
WHOLESALE CLOTHIERS OF CHICAGO. 

At 2 P. M. May 10, the Conference met a committee representing the 
wholesale clothing manufacturers of Chicago, composed of Harry Hart, 
of Hart, Schaffner & Mark ; E. P. Griswold, of Griswold, Palmer & Co.; 
Fred Siegel, of Fred Siegel ct Bro.; A. Kuh, of Kuh, Nathen & Fischer; 
H. D. Kohn, of Kohn Brothers ; Felix Kahn, of Kahn, Schoonbrun & Co.; 
S. Spitz, of Spitz, Laudauer & Co., and John Prentiss, of C. P. Kellogg & 
Co. Dr. Reynolds, health commissioner of Chicago, and Mrs. Florence 



no ANNUAL REPORT 

Kelley, State inspector of factories of Illinois, were also present. Dr. J. 
W. Scott, of Illinois, in the chair. 

The Chair : This Conference was called at the instigation of Dr. 
Probst, as secretary of the National Conference of State Boards of Health. 
At our meeting last night it was decided to issue an invitation to the 
manufacturers of all articles that are made in svveat-shops, as they are 
called. I understand that this is a committee to represent the manu- 
facturers of that kind of articles in the city. We have prepared an out- 
line of what we suggest to you, and it is purely with a friendly spirit that 
we have called this meeting. 

Mr. Harry Hart (of Hart, Schaffner S: Mark) : Mr. Chairman : In 
l^ehalf of the clothing manufacturers of the city of Chicago, and in behalf 
of manufacturers of all sorts of textile garments, I would say, we are 
perfectly willing and anxious to adopt any suggestion which you might 
think would assist us in stamping out the disease; that we have a great 
interest at stake, in fact it is our own life, our bread and butter, to see to 
it that this disease is stamped out here. We will put nothing in your 
way in the shape of an obstruction to do anything that shall be necessary 
to stamp out the disease in the city of Chicago. What we do object to is 
that we should be singled out as perhaps the only single line of interest, 
that is, line of manufacturers, who are propagating the disease. As far as 
the clothiers of Chicago are concerned — I can speak for our firm and every 
clothing firm in Chicago — we have compelled the people who work for us 
to vaccinate their employes, and we will do anything else that you will 
suggest that will assist in stamping out this disease. 

The Chair: Dr. Probst has had this matter under consideration 
perhaps more than anybody else present, and perhaps he could give us 
an idea of the reasons why these particular articles of manufacture are 
singled out. 

Dr. Probst: Mr. Chairman, I do not wish especially to respond to- 
that, but, if it would be in order, and you will permit me, I will submit 
to the meeting the resolutions that were adopted by our joint conference 
with reference to precautions that we think should be taken to protect 
surrounding states and your own State against any danger from infection 
from clothing sent from this city. 

Ptesolution No. 1 (vide supra) was here read. 

Mr. Hart : If the Doctor will excuse me for just one minute, clothing 
in the usual sense means simply ready-made clothing for men's wear. 
Clothing, as I would understand it, would be cloaks, shirts, anything that 
is made in textile garments, and if this thing goes out into the newspapers 
before this article is published, I would suggest to the Doctor that he should 
embody the whole thing in there. It is no more dangerous to manufacture 



OHIO STATE BOARD OF HEALTH. Ill 

clothing in an infected district than it is a cloak or a shirt, cotton or 
woolen. 

The Chair: We do not make this distinction. 

Mr. Hart: I should like to hear from Dr. Reynolds. 

Dr. Reynolds : Is this intended to act independent of the city 
government ? 

The Chair: Not at all, sir. My own idea was that it should be left 
in the hands of the city government. The object is simply this: These 
gentlemen are representatives of State Boards of Health, and they insist 
upon having their authority come from a corresponding authority in the 
state of Illinois. They insist upon having their information directly 
from the authority in Illinois that corresponds with the authority they 
represent in other states. Furthermore, it will bring into co-operation 
other state officers who already have charge, in connection with the State 
Board of Health, of this work, namely, the factory inspectors, who are 
more directly connected with this work even than the local board of 
health. 

Dr. Ramsey : Before it is discussed further, I would move that the 
words "manufacturers of clothing" be changed to "manufacturers of all 
textiles."' 

The motion was seconded and carried. 

Mr. Kuh (of Kuh, Nathen & Fischer): I have a suggestion here for 
this committee, and if you will be kind enough to read it, and find it 
advisable to adopt it, I shall be pleased to have you do so. 

The suggestion was read by the secretary. 

Mr. Prentiss (of C. P. Kellogg & Co.): It seems that that is a matter of 
detail that comes afterwards. The matter now is, whether the State is 
going to take this matter up, or whether it is the city. It seems to me 
that it might do great harm to the city. It is a question of authority. 
Who is going to do this work ? If the State is going to do it, who is to pay 
the expense? It seems to me if the State Board takes it the city board 
of health can step to one side and let the State Board manage the business 
themselves. If the State Board will recognize the health officer and the 
city government, and aid them with what help we can give them to stamp 
this out, it can be done readily ; but if the State is going to assume charge 
of this matter it will be very great injury to the city. 

Dr. Baker: I rise to make the request that each speaker give us the 
benefit of his personality. I would like to know who each speaker is, so 
that we may know whom we hear. 

Mr. Hart: I would like to have the opinion of Dr. Reynolds, the 
head of the health department of the city of Chicago. 



112 ANNUAL REPORT 

The Chair : We are very desirous of hearing from Dr. Reynolds, and 
I wish to assure Dr. Reynolds, and the local health department, that this 
is not intended to take anything from his authority or control. Dr. 
Reynolds realizes, I think, that there has been no disposition on the part 
of the State Board to interfere with his work in any way. On the contrary, 
I think he knows that the State Board of Health has done everything in 
its power to co-operate and strengthen his hands whenever it was possible. 

Dr. Reynolds: If I am to speak to this resolution, Mr. Chairman, I 
shall have to hear it read again. If I am to talk in a general way 

The Chair: We should like to hear you talk in a general way first. 

Dr. Reynolds: Mr. President, gentlemen and ladies. I was asked 
this morning by a committee of a meeting held yesterday, to meet with 
this committee this afternoon. Oft arriving here I find that you have 
business with the manufacturers of Chicago. That is the first intimation 
I have had of that, outside of the morniDg papers. When the committee 
waited on me this morning I dictated to a stenographer some things which 
I supposed the gentlemen present would like to hear. I did not know 
then that the manufacturers were to be here. Perhaps they would like 
to hear them also. 

Since the year 1851 there have been but four years when there were 
no deaths recorded in Chicago from small-pox — the years 1858, 1888, 1890 
and 1891. In the year 1882 there were 3,611 cases with 1,292 deaths, 
being the highest number ever recorded. The year previous there were 
2,997 cases with 1,180 deaths. Three years in that time — 1879, 1886 and 
1889 — each had one death. There were eight cases in 1892, 140 cases in 
1893, During 1894, up to last night. May 9, there were 1,459 cases. Our 
population in 1882 was 560,639, and in round numbers at the present 
time it is 1,600,000. 

Various times in the history of Chicago small-pox has been found and 
destroyed. In 1881 and 1882 there was an enormous amount of small- pox 
compared with the population. We were not then, as now, the focal 
point lor all points of the world, yet it flourished. In 1892 and 1893, in 
addition to the usual travel centering in Chicago, every known country 
on the face of the earth had its representatives here. Without question 
visitors to the World's Fair brought small-pox to our country and to our 
city. In July last three cases of small-pox were found, each miles from 
the other, at the same time. Ever since cases have been occurring where 
it is impossible to trace them to their origin. That small-pox was brought 
again and again to Chicago, and is still being imported, cannot be ques- 
tioned. That small-pox has been destroyed again and again in Chicago, 
we know. Small-pox has not spread in Chicago from houses disinfected 
by us. 



OHIO STATE BOARD OF HEALTH. II3 

At the present time the entire city is being canvafsed. More espec- 
ially in the vicinities where small-pox is existing, or has existed, with 
the result that we are now finding many cases that are purposely hidden 
from us. Vaccination is being practiced now in Chicago at the rate of 
from five to fifteen thousand per day, and we can safely challenge any 
municipality in our country, or any other, in this or any other time, as 
to the quantity and character of this work. So careful are we as to re- 
vaccinaiion that in one instance vaccination was repeated fourteen times 
before it was successful. 

Our methods for disinfection are with a solution of bichloride of mer- 
cury, 1 to 500, and with Jumes of sulphur. When we disinfect a house, 
everything, including woodwork and fabrics of all kinds, is saturated with 
this solution of bichloride of mercury. The sulphur is burned, three 
pounds to 1,000 cubic ftet of air space, in an iron kettle set down in tuba 
of water. Such goods as mattresses, where we have reason to doubt that 
this application may disinfect, we-destroy by burning. 

That clothing is baing shipped from the city, that has been in- 
fected, I do not believe, as our method is to either disinfect it or destroy 
it, or take it and use it for our patients in the small-pox hospital. Our 
death rate is no higher than in other outbreaks of the disease in the past, 
but we have been crowded for room and quarters are being created as fast 
as men and money can do it. By the close of the week we expect to have 
every case in the city removed and cared for properly. We have a maa 
with a wagon, whose business it is to secure supplies and feed those in 
quarantine, and I believe it is being faithfully done. Several lodging 
houses and hotels were infected during the winter, but the disease has not 
reappeared since we treated the premises. 

That is all I have written. Now if our methods were not right in 
such places as the lodging houses in Chicago, where sometimes five and 
as high as seven htmdred people under one roof are crowded together, if 
our methods, I siy, w«rre not right, we would s'ill be having small-pox 
by scores in those regions, because there are probably 20,000 people who 
live in lodging houses in Chicago. Occasionally, since that time, we have 
taken a man out of a lodging house, but you know they stay there as a 
rule bu^ one night, m?<y be somewhere else the next. Secondly, cases have 
not appeartd in houses whence any ot those cases have been removed, or 
any infection from these premises. Oar experience shows most conclusively 
that vaccination is a preventive, and we vaccinated in January 87,500^ 
that is, we paid for that many vaccine points. A few may have been 
wasted, some may have been ustd on secondary vaccinations. Since 
December 1st up to the present time, we have probably used over 300,000 

8 ST. B. H. 



114 ANNUAL REPORT 

Tacci nation points. Nevertheless, there are probably thousands still un- 
vaccinated. We have a force of over one hundred people working on 
small-pox, and it will be a question of but a short time before every one 
is vaccinated. It must be remembered, however, that there are strangers 
coming to and going from the city ; probably a transient population of 
ten thousand in our city, maybe far more. That there will constantly be 
some people who need vaccination, we cannot question. 

Mr. Holt : Before the doctor gets through I would like to have him 
state to the meeting what his plan is in case of finding small-pox where 
\here is any clothing or shirts or any other textile garments manufactured. 

Dr. Reynolds : I believe that cotton and linen fabrics can be disin- 
fected in many ways by heat, by being saturated in a solution of bichloride 
of mercury of sufficient strength. For woolen goods, fumigation and 
treatment this way may destroy them. The quickest way with them is 
\o burn them. 

Dr. Probst: It you will pardon me, I understand the question is not 
what should be done, but what is being done. 

Dr. Reynolds : One firm, where there were some clothes unfinished, 
sent word to those who were manufacturing them to finish them and turn 
them over to the department of health. We put them in our small- pox 
liospital and used them to clotke the pa'ients there. Men came with 
almost no clothes. 

Mr. Holt: Is that the only way ? 

Dr. Reynolds: No; many of them were destroyed or disinfected. 
We have the State inspectors, who are, I believe, clothed with authority. 

The Chair: Under the law, factory inspectors are obliged to burn 
clothing, aren't they ? 

Dr. Reynolds : I was about to say, these factory inspectors are clothed 
with authority to notify th« various boards to destroy goods. When we 
receive a written notice of that kind from them, these goods will be des- 
troyed. I wish to say further, we are putting men to work as fast as we 
can find work for them to do, as last as we can keep the work systemized, 
and keep them working without being in each other's way. We have 
about one hundred now. If it needs a thousand, they will be put to work. 

The Chair : How about the sufficiency of your quarantine, where 
you have people in houses that are not taken to hospitals or pest houses ? 

Dr. Reynolds: I do not believe in treating small-pox in private 
liouses at all. 

The Chair : Have you been able to maintain any adequate quaran- 
tine under the circumstances? 



0H[0 STATE BOARD OF HEALTH. II5 

Dr. Reynolds : At the end of this week we will be able to house 
them all. We have depended principally upon the police force for 
quarantine. In moet parts of the city this has been efiective; as effective 
probably as any quarantine of this kind can be. Human nature is frail, 
and people will be negectful, and that quarantine will be air tight I of 
course have no way of knowing in each individual case. From what I 
have learned in the past few days about one section of the city, the 
Southwestern, I know it is not; it has been almost impossible to get a 
policeman to go near the houses at all. That has been guarded against, 
and if the cases cannot be removed, we will have to quarantine them with 
our own men. 

The Chair: The State factory inspector, Mrs. Kelley, is present, and 
I presume would like to say something about the factory law as it affects 
this matter, and the rtsult of some of the work that she has done in this 
direction. 

Mrs. Kelley : Mr. Chairman, may I ask that the resolution be read 
once more? We are all speaking to a resolution, aren't we? 

The Chair : We propose to get to the resolution pretty soon, but 
anything in regard to your work as it affects clothing, will be in order. 

Mrs. Kelley : I made a small statement this morning of what we 
have been doing the last few month, which I have addressed to you as 
Secretary of the State Board of Health. 

if ay 10, 1894. 
Db. Scott, Secretaru State Board of Health of lIKnois : 

Dear Dr. Scott: la accordance with your request I su'j )in a statement of the 
action of the State inspectors in connection with the smal'-pox epidemic in Chicago. 

When small-pox first appeared in those streets in which it is now found in juxta- 
position to clothing in process of manufacture, the clothina; trade was so dull that the 
most careful inspection failed to find infected gods This continued to be the case 
throughout Decemb.r and January, during which months daily schedules were filtd in 
this offi -e showing continuous searching of the region now so disastrously infected. 

During the tir>t w ek in February, a rumor, which we cou d not substantiate, 
reached the inspectors that small-pox was being concealed in one tenement house where 
clothing was being made, on West iSih street. The ac. ompanying circular was sent 
immediately to 176 wholesale merchant tailors, and to several hundred of the sweaters. 
A deputy inspector was detailed to visit every wholesale dealer and obtain a corrected 
list of sweaters. Another deputy visited sweaters to obtain perfect lists ol home fiaish- 
ers. The search for infected garments was kept up unbroken iy. 

During the first week in March the deputies reported in one day three cases of 
disease which they believed to hi infectious. I went to tha offi;e of the Board of Hedrh, 
but failed to fiad Dr. Rey lol Is. I saw Dr. Ciirrott aud shovv^d him the fictocy and 
workshop laws, and asked him to detail a physician to make the diagnosis He did this 
but assured me that by order of Dr. Reynolds, the Board of Healih would in no way 
destroy goods. 



I 1 6 ANNUAL REPORT 

The law provides that : 

"If the Board of Health of any city, or said State inspector, finds evidence of in- 
fectious or contagious disease present in any workshop, or in goods manufactured 
or in process of manufacture therein, and if said Board or inspector shall find said shop 
in an unheahhy condition, or the clothing and materials used therein to be unfit for 
use, said Board or inspector shall issue such order or orders as the public health may 
require, and the Board of Health is hereby enjoined to condemn and destroy all such 
infectious and contagious articles." 

We have in all cases issued the orders to the sweater and the wholesaler, that in- 
fected goods must be held for destruction by the Board of Health, and that no more goods 
must be sent to infected places. But the order of the Board of Health has not always 
been made formally, in writing, because there is no requirement that it should be so 
made, and because at first we were certainly justified in assuming that the commis- 
sioner was as much concerned as we in obeying the law and stamping out the epidemic. 
Wherever the notice given to the health department was verbal, instead of written, it 
was done to save time and to enable the department to take instant action, one inspector 
standing guard over the infectious goods while another made the report in perf^on to 
Commissioner Reynolds or Secretary McCarthy. This precaution was early found to be 
necessary because the sweater would carry back the infected garments to the wholesaler 
in defiance of orders and to the incalculable injury of the purchasing public. Any 
excuse on the ground of lack of written notice is, therefore, a confession of bad faith of 
the health department which has been made thoroughly aware of the circumstances of 
the case. 

Concerning our effort to induce clothing manufacturers to insist up'>n vaccination 
of all employes, you are already informed. We have found the manufacturers prompt 
to comply with every ordtr, exci'pt the two firn:s, H. Msrks & Co., 189 Clark street, atd 
Henig, 141 Michigan avenue, who flatiy refused to obey the Jaw. 

We are, however, constrained to state that the law as it stands to-day affords the 
purchasing public no adequate protection against small-pox, or any other infectious dis- 
ease, because the interests of the tenement house worker is wholly in the direction of con- 
cealment. Hence neither the Board of Heaitk nor the State inspectors can hope to 
know the state of health of all the families of the twenty-seven thousand persons engaged 
in Chicago in the manufacture of clothing in tenement houses. The most efiicient co- 
operation of the Board of Health, the wholesalers, merchant tailors and State inspectors 
could, under the most favorable circumstances, aflord but a panial and inadequate pro- 
tection of the public health while the tenement house manufacture is tole/ated. There 
can never be any assurance of freedom from inftction from this source until tenement 
bouse manufacture is absolutely prohibited in the interest of the j.ublic health. 

This recommendation we shall make to the next Legislature, supported by the 
records of the present epidemic. Meanwhile I most urgently insist th.it no work should 
be given out to any tenement house during the next six months. 

We shall continue to fight the epidemic with all the co-operation that we can secure, 
and shall be gratelul for any helpful suggei-tions that you may be able to make. 
(Signed) Florence Kelley. 

During the reading of her address, Mrs. Kelley made the following 
remarks : 

We found nine hundred and fifty shops employing from six to fifteen 
people each ; that is to say, nine hundred and fifty sweat-shops. There 
are one hundred and seventy-six down town shops, in which the so-called 
inside hands, the people that work in the first ward, were vaccinated some 
four to six weeks ago ; but the vaccination of the people in the nine hun- 



OHIO STATE BOARD OF HEALTH. II7 

dred and fifty shops I was not clever enough to think about, but when it 
was suggested to me, Dr. Reynolds sent out a circular, and I believe they 
are being vaccinated, but nothing was done previously to the people in 
those shops. They are principally Swedes, Russian Jews and Italians, 
and we did not find many who had been vaccinated. They have a per- 
fect horror of it. 

You will notice there is a clause there which says : " The Board of 
Health is enjoined to destroy goods upon receiving written instructions 
from the inspectors." We say : " Now don't take these goods out of the 
shop," and we telephone to the wholesalers. We have no complaint to 
make whatever of any lack of zeal on the part of the wholesalers. 

If the wholesalers and the doctor and I work together every single 
day faithfully, we cannot know what is the condition of the thirty thou- 
sand working people in Chicago. It would not be honest for us to claim 
that we did. We cannot. The only way that will, to my mind, prevent 
sending out infectious goods, is the agreement on the part of the whole- 
salers that for the next six months they will have goods made in their 
factories, or that they will not have them made at all. We cannot guar- 
antee that any tenement house is clean. 

Mr. Kuh : The statement made by Mrs. Kelley I am satisfied is cor- 
rect. I am likewise satisfied that Mrs. Kelley and her board have done 
all in their power, as well as the health officer, and at the same time the 
manufacturers of Chicago have not done their duty as they ought, and I 
think the manufacturers could assist our health officers to a very large 
extent by uniting with one another. What I mean to say is this : That 
we positively refuse to employ tailors or any one of their assistants or em- 
ployes without their being vaccinated, and I tbink in that manner we 
might be able to stamp out the disease. Now the question comes, it will 
require a great many more assistant inspectors, and I presume it will 
require a great many physicians. Now for instance, our firm may have a 
dozen shops, or a hundred of them. In this resolution I say that every 
clothier shall be required to send a representative with an inspector or 
physician to see that the people in those shops are vaccinated, under the 
threat of discharge. I am positive that any employe of ours, or anybody 
else, for fear of being discharged, will submit to vaccination, and I think 
if everybody is vaccinated in these shops that the disease can be rooted 
out. 

Mr. Kohn (of Kohn Brothers) : Mrs. Kelley, in speaking of the 
manufacture of clothing for the next six months, says, that none shall be 
made in homes; I suppose she means of the workman. 

Mrs. Kelley : Tenement houses. 



Il8 ANNUAL REPORT 

Mr. Kohn : I would like to ask Mrs. Kelley where she would have 
them made. 

Mrs. Kelley: Every other form of manufacture in Illinois, exoept 
this one of garments, is carried on in factories, and in the name of the 
public health that ought to be. 

Mr. Kohn : I would like to ask Mrs. Kelley if within six months, it 
would be possible to arrange for the wholesalers and their employes so as 
to enable them to provide facilities sufficient, both as regards room and 
sanitary appliances and anything else that may be necessary to do the 
work. I wonder if Mrs. Kelley realizes the amount of clothing made in 
Chicago ? I do not refer particularly to men's clothing ; I mean every- 
thing that is made. Of course I am not personally posted as to how 
much is made in what is called sweat-shops. I suppose there are grades 
of that kind of work, some very bad, and from that degree they go up, 
perhaps, to some satisfactory to everybody. So far as making clothing in 
shops is concerned, is there not just as much danger in the workingman 
bringing infection from his own home, if it is not sanitary,, if he is hot 
vaccinated, if everyone in his family is not vaccinated, to a shop in which 
he may be employed, as there is danger of small-pox in the sweat-shop 
itself where every one is vaccinated ? 

Mrs. Kelley : In answer to those two questions I would say that I 
think I have a very fair appreciation of the vast quantity of clothing 
made, when I have, as I said, a schedule of nine hundred and fifty dif- 
ferent sweat-shops, and when we have between twenty-seven and thirty 
thousand home workers on our list, actual addresses furnished us by the 
wholesalers and by sweaters. But I do think, in the interest of publi-e 
health, the manufacturers are in duty bound to make every efiort to 
supply themselves with such factories as other manufacturers have, and if 
they cannot, I think they ought to slacken up a little bit until they can. 
As to the second question, as to the danger; in the first place, if one man 
goes from a tenement house to a factory there is one chance of his carry- 
ing infection from whence he comes. The majority of tenement houses 
in which the garments are made are very large, three buildings on a city 
lot, four, five and six stories high, crammed with tenements. There is 
absolutely no possibility of quarantine where there is a case of small-pox. 
The water closets are used in common, the stairway is used in common, 
The passage way along the halls and to the street is used in common, 
and the children play together all the time ; and if a garment goes there 
there is a chance of infection from every tenant in the house. If the 
workers go to the factory there is one chance of his carrying infection 
with him. (Applause.) 



OHPO STATE BOARD OF HEALTH-. I I9 

Mr. Kohn: While Mrs. Kelley's remedy perhaps may be efiected in 
time, she suggests that some of the largest industries here practically stop 
working for six months. During that time the prowess of Chicago will be 
lost, the employment of a great many thousand people will be lost. 

The Chair : This is a very interesting subject for discussion, but it is 
getting away from the business in hand. 

Mr. Kohn : I would like Mrs. Kelley's definition of a sweat-shop. 

Mrs. Kelley : The English Commission on Labor which examined 
the sweating system for several months declared when they got through 
that they had eighty definitions, any one of which would be suitable ; but 
that they thought the best definition was a room in a tenement house iik 
which a man worked upon garments that did not belong to him, for which 
he received compensation from their owner and returned to their owner. 
And that is what I understand exactly by a sweat-shop ; and that a sweater 
is a man who lives in the tenement house, or who has his shop on the 
same lot with the tenement house, who takes goods from a • manufacturer 
and returns them. 

Dr. Probst : It seems to me this discussion will go on interminably 
unless we bring it to a focus. I think it is proper that we should consider 
the resolution presented by the Conference. The plan was that every 
so-called sweat-shop should be inspected daily. The idea, of course, is 
that if there is a case of sickness in that house it will be discovered at 
once, and all precautions taken. Such a plan was carried out and found 
practicable in Cincinnati in 1882, when they had an epidemic of small- 
pox in that city. The Kentucky authorities came there and proposed 
that they would not allow any clothing to come into Kentucky. A meet- 
ting similar to this was called. The clothiers agreed to pay the expense 
of an inspection that would be satisfactory to the authorities of Kentucky. 
They placed this inspection in charge of a physician who worked in en- 
tire harmony with the local board of health. They had a list of every 
sweat-shop and every inmate of the house. They were visited every day 
by a medical man and the inmates all came up and were examined, to see 
that no one was sick. This daily inspection was carried on during the 
epidemic. I do not think it necessary that we should attempt now to stop 
the sweat-shop system of making clothing in Chicago ; an examination, 
of these shops by a competent man ought to make us feel safe. 

Mr. Hart : I perfectly agree with what Dr. Probst has said. I think 
if a daily inspection were to be required of each shop in the city where 
there is manufacturing of either men's or women's clothing, and it waa 
found that no disease was there, it would be perfectly satisfactory to have 
the clothing go out among the people of the different states. In regard t® 
shutting up the nine hundred shops, as Mrs. Kelley suggests, it would 



I20 ANNUAL REPORT 

simply kill the industry of the city. It might suit her very well to have 
the industry killed, but at the same time I do not think the city of 
Chicago would be helped. 

Mrs. Kelley : It has not killed the shoe industry. 

Mr. Hart: Shoes are different from clothing. The whole trade 
would have to be revolutionized. I move the previous question on the 
resolution of Dr. Probst. I move that it be adopted. 

Dr. Ramsey : I do not think this Conference has any idea of stating 
where clothing or textile garments of any kind shall be mada The only 
idea is to make it safe to be shipped into our states. I think the resolu- 
tion covers that. 

The Chair : Before this resolution is put upon its passage allow me 
1,0 say that this is a demand made upon the Illinois State Board of Health 
without any previous knowledge on my part. I cannot say that the 
Illinois State Board of Health will guarantee this. I have never pledged 
myself to assume it. I have never pledged the Board to assume it. I 
have no doubt if the manufacturers express a desire that the State Board 
of Health, in accordance with established regulations between State Boards 
of Health, should act, through whatever inspectors they may see fit to 
endorse, merely making itself responsible for the assurance that goes out, 
that it will do so. 

Dr. Baker : I rise for the purpose of asking a few questions. Dr. 
Reeve has asked me to vote on this question. I would like to have, be- 
fore this vote is taken, the names of the manufacturers represented here, 
and then let us understand who votes, and those of us from abroad of 
course refrain from voting. We have had our say. We have made our 
proposition. What we wish to hear from, I think, is the manufacturing 
interest here in Chicago. 

The Chair : How many manufacturers were represented at the meet- 
ing this morning that appointed this committee of nine ? 

Mr. Holt : The entire clothing industry is represented. Those who 
were not there will come in. 

Dr. Baker : One more point, and that is, suppose this plan, which 
has been read here, is adopted, who pays the bill? Is the Illinois Board 
of Health prepared to meet the expense, or does this vote that is taken 
here pltdge the manufacturers themselves to meet the expense? 

Mr. Kuh : That is the very question I asked Dr. Reynolds and Mrs. 
Kelley. I do not know whether you propose to adopt the suggestion 
which I made about the doctors. Who is going to pay the expense? Who 
is going to pay the additional inspectors? Who is to engage additional 
physicians if the resolution should go through ? 



OHIO STATE BOARD OF HEALTH. I2l 

Mr. Hart: I have just been asked whether the manufacturers of Chi- 
cago would be willing to pay for this inspection, and I said in behalf of 
the manufacturers that I thought they would be. 

The Chair : Dr. Reynolds has been spoken for on this matter, but he 
has not spoken. I would like to hear whether Dr. Reynolds has any ob- 
jection to this method of having reports authenticated to boards of health 
by the Illinois State Board of Health. 

Dr. Reynolds : Not in the least. 

Mr. Spitz (of Spitz, Laudauer & Co.): Allow me also to say that the 
clothing manufacturers do not want the impression to go abroad that they 
have done nothing until now to prevent the spread of small-pox. Indi- 
vidually, for the past three or four weeks, they have done all that they 
possibly could to have their employes vaccinated, to have certificates sent 
to them from the different shops. They have sent men from their stores, 
who have inspected the different shops and have brought back word 
whether, in that vicinity, small-pox prevailed or not ; and this impression 
should go abroad among these different gentlemen who are representing 
the State boards, that the clothing manufacturers of Chicago have already 
used every precaution in their power to allay this disease, and send cloth- 
ing forth that has been made in shops free from disease. 

Mr. Prentiss : I cannot .^^peak for the other clothing manufacturers 
in Chicago, but for the one I represent I do not believe there has an arti- 
cle ot clothing gone to a sweat-shop as defined by Mrs. Kelley. We are 
sending our clothing to reputable shops. We do not send clothing to 
tenement houses to our knowledge. If any case is brought to our knowl- 
edge of that kind the clothing is taken away from them; in fact, I do not 
think it has ever been. If there are nine hundred sweat-shops of that 
character, how many reputable shops are there? Mrs. Kelley does not 
state that. 

Mrs. Kelley : There are none. 

Mr. Prentiss : If that is so the clothing men had better resolve to 
stop manufacturing clothing and throw these people that are doing work 
out of employment, and I ior one would be in favor of that. And I 
would ask the gentlemen with me that not another garment should go 
out of our shops after to-day. 

The resolution was again read. 

Dr. Reynolds: May I say one word ? That is, when these men are 
employed, as these State inspectors have worked so well in the matter and 
know where all the shops are, I think the men ought to work under their 
direction. I think it ought to be perhaps so understood in advance. 

Dr. Baker : In co-operation with the State factory inspectors? 



122 ANNUAL REPORT 

Dr. Reynolds : That they direct the work, because they are the ones 
who know where the shops are. Of course they come directly under the 
city diepArtment of health. When they find any clothing we are supposed to 
destroy it. They come under our observation as well. These men can 
communicate with the State Board of Health, and the State Board of 
Health can send out any communications, they receive. 

Mr. Prentiss: Do I understand this takes it entirely out of the hands 
of the city, the work of exterminating small-pox, and places it under the 
supervision only of the State Board of Health ? 

The Chair: Allow me to assure you personally that there will be no 
antagonism between the State Board of Health and the commissioner of 
health of Chicago. I think Dr. Reynolds is thoroughly satisfied that that 
is so. 

Dr. Reynolds: It is not possible to take it out of the hands of the 
department of health. The department of health is working under laws 
and ordinances, both State and municipal, that are broad. There can be 
no objection on my part nor on the city's part to having these men report. 
Of course they must report to me when they find contagion, and there is 
no objection to their reporting to the State Board of Health. We do, too. 
That makes a short cut to the State Board, and they can communicate 
with other boards. So far as the city is concerned, I want it understood 
that the city understands that it is to destroy contagion wherever found 
and of whatever kind. 

Dr. Baker : May I supplement what Dr. Reynolds says by suggesting 
another idea? That as eventually this is to satisfy the State of Michigan, 
the State of Illinois, the States of Wisconsin, Indiana and Ohio, the de- 
tails of this plan should be submitted by the State Board of Illinois to 
these surrounding states, and preferably in advance so that they may find 
out whether or not it is satistactory. I make that suggestion as some of 
us have been considering for a considerable time quarantining against 
Chicago. Quarantining against Chicago is a large undertaking, especially 
for a State like mine, with so long a seacoast, as we have too many points 
to guard. Still the life and health of our people are of that consequence 
that under some circumstances, of course, we will quarantine against Chi- 
cago. The measures taken here have a bearing on our action, not only in 
Michigan, but in Wisconsin, Ohio and Indiana, so that before this plan is 
finally started, or when it is started, it seems to me we should expect to 
have notice from the Illinois State Board of Health as to the exact plan. 

The question was called for. 

The Chair: As I understand it, this is a question for the committee 
representing the manufacturers to decide. We have submitted the 
proposition; we have nothing to do with voting on the question. It is 



OHIO STATE BOARD OF HEALTH. I 23 

simply whether the manufacturers will accept the proposition submitted, 
provided it caii be completed and carried out as suggested, and I have no 
doubt it can, in conjunction with the local health officers of the city of 
Chicago. 

Mr. Hart: Do I understand that this work is to be done under the 
immediate supervision of th« local health officers? 

The Chair : The State Board of Health of Illinois is held responsible, 
as I understand it, for the reports that go out from this city, as to whether 
or not any of these articles of clothing have been exposed to any con- 
tagion. You know what that means as well as anybody else. You know 
if the Sta<te Board of Health assumes that responsibility it must have 
some say as to how this work shall be done. Nobody questions Dr. 
Reynolds' authority in this city, and Dr. Reynolds and I understand 
each other; if we do not, we will before we get through. 

Mr. Prentiss : As one of the members of that committee, I will ex- 
press myself as desiring to co-operate with the State Board and the city, 
and do anything that is possible to prevent the spread of the disease of 
small-pox, and I will vote favorably for that resolution. 

Dr. Reynolds : In the paper submitted by the manufacturers here, I 
find this suggestion : " The manufacturer, however, to be furnished with 
a certificate from an inspector that the work has been fumigated before 
he shall accept the same." Now, I think, it would be well to have these 
inspectors furnish these manufacturers a certificate that the goods are free 
from contagion, or are disinfected, or destroyed, or what has become of 
them. 

The Chair: As this resolution that is presented treats of placing 
goods in trade as well as shipping them out ol the city, I think it would 
be perfectly right to have it appear in that resolution, that a certificate 
also be furnished to the manufacturers for their defense. They are en- 
titled to something out of this. They are paying the expense for the 
additional work. 

The resolution originally proposed was then read as follows : 

"That an efficient daily inspection of all places in which said goods are manu- 
factured in the city of Chicago, be eetablished and maintained under the direct super- 
vision of the Illinois State Board of Health, to the end that no such articles from any 
infected locality shall be put on the market for sale or shipment, or be otherwise dis- 
tributed to the menace of the public health." 

Mr. Hart: I would like to make one suggestion, and that is in say- 
ing that the inspection shall be under the supervision of the State Board 
of Health in coDJunction with the city board of health. I think that 
would cover the ground still more thoroughly. The State Board and 



124 ANNUAL REPORT 

city board really have one interest, and the State Board cannot do any- 
thing without having the city authorities connected with itt 

The Chair: If there are no objections to the introduction of that 
clause in this resrlution, it will be introduced. Has anybody any 
objection ? 

Dr. Reynolds: I myself think it would scarcely be wise. Now, we 
issue certificates, for instance, what would be the necessity of my otHoers 
issuing a certificate and the State officers issuing a certificate? Besides, 
this is done largely to allay fear abroad. The city department deals only 
within the corporate limits of Chicago, and the State Board handles State 
matters, and it is all right and proper to read as it is. While I am on my 
feet I will also say that when these inspectors inspect shops, they must 
inspect employes and follow them to their homes. 

Dr. Reilly : There is a good deal of useless discussion. As I under- 
stand it, our object is first to protect the public health, and secondly and 
only less important, to protect commercial interests. This whole question 
of certificates has been definitely abandoned by every representative' of 
State boards of health here. You do not want your goods tagged with a 
certificate and marked free from small-pox. You do not want to give the 
impression that contagion is so general that goods must be marked free 
from it. It will throw suspicion on the goods. The more quietly this 
can be done the better. It can be done here as in Cincinnati. The 
guarantee for the adjoining States is the guarantee of the State Board of 
Health. It will be Dr. Scott's duty to formulate a plan for this service 
to be submitted to the representatives. It must, be acceptable to the 
State boards of health. In doing that, he will naturally confer with Dr. 
Reynolds and Mrs. Kelley. He will naturally confer with representatives 
of manufacturers. Now the whole matter rests in his hands to draft that 
first plan, to submit it to these gentlemen for their acceptance. You 
don't want a certificate. You don't want it heralded to the world that 
the clothing of Chicago is of such a suspicious character you have to 
certify to its purity. (Applause.) 

Mr. Hart: In behalf of the manufacturers of Chicago, we accept the 
resolution, and we shall see to it that a sufficient number of inspectors 
are appointed and paid to inspect all the work that y:e are turning out. 
(Applause.) 

The meeting then adjourned. 



OHIO STATE BOARD OF HEALTH. 1 25 

SMALL POX IN OHIO. 

The following is an abstract of the reports of the various outbreaks 
of small- pox which occurred in Ohio during the year, as presented to the 
State Board of Health at its quarterly meetings: 

WEST WILLIAMSriELD. 

The township health authorities, in October, reported that a child in 
a family living near West Williamsfield, Ashtabula county, had small- 
pox; that quarantine had been efctablished, and proper precautions were 
being taken. The attending physician reporting on the origin of the 
disease stated that there bad been no exposure to small pox, and that the 
case undoubtedly came from vaccination. Further inquiry made it 
practically certain that the case was simply vaccinae, with a general 
eruption which occasionally follows vaccination. 

HARROD. 

A similar casp, but of more interest, occurred in Harrod, near Lima, 
Dr. Kahle, a member of the State Board of Health, investigating it. A 
chile, following vaccination, presented the vaccinal eruption. An infant 
in the family, which had not been vaccinated, Liter had a similar 
eruption, and this gave rise to the report that the disease was small-pox. 
Dr. Kahle, after investigation, reported that the infant had been accident- 
ally inocula^ed with vaccine virus by the ciaild first having the eruption, 
and who frequently nursed it. The eruption was therefore of vaccinal 
origin in both cases. A number of cases of vaccinal eruption were 
reported during the year. 

COLUMBUS. 

The first r al case of small-pox occurred in Columbus, and was 
reported December 1, 1893. An Italian called at a physician's office for 
treatment. The physician telephoned me that he feared the man had 
small-pox. I instructed him to report to the local health department at 
once, and see that the man was taken home and guarded until the health 
officer took charge of the case. The man gave a false address, was allowed 
to go without watchirg, and disappeared. Diligent search was made for 
him several days. I spent a day in hunting up Italian quarters outside 
of the city looking fur the man, but he was never found. 

December 18, Dr. Kinsman, health officer, reported a case of small- 
pox in a child living in a house on the west side of High street viaduct. 
On the following d.-iy I saw the case with him, and was doubtful about its 
being a case of small-pox, but as Dr. Kinsman was of the opinion that it 



126 ANNUAL REPORT 

was, and the attending physician had so pronounced it, I concurred in 
the advisability of maintaining quarantine. Quite a number had been 
exposed to the patient — a child of probably three years — and as most of 
these were not hunted up and vaccinated, as they should have been, and 
yet none of them contracted the disease, my opinion that it was not small- 
pox has been strengthened. 

A case of small-pox was reported on West Town street, this city, ten 
days ago, about January 16, in a babe a few days old. No known source 
of exposure. The local authorities promptly quarantined the case, and 
there have been no other cases reported. 

The next case in Columbus, Frank Rose, was reported sick February 
24. He was a railroad engineer running into Chicago, and is suspected 
to have contracted the disease in that city. He was taken sick in a 
boarding house on East Gay street about the 18th, and was removed t© 
St, Francis Hospital the iollowing day, the nature of his disease not 
being suspected. He was taken to the small-pox hospital on the 25th 
and died there March 2. Those in St. Francis Hospital who had been 
most exposed to the patient were vaccinaied, and the inmates were held 
in quarantine for a lew days only. 

Herman Donavan, who was in the ward with Rose in St. Francis, 
and who had been unsuccessiully vaccinated, was found sick with small- 
pox March 11 in a stable in the central part oi the city. He was removed 
to an improvised pest house, a tent (the building occupied by Rose having 
been destroyed by fire), on the following day. He was discharged April 
12. Undoubtedly he contracted the disease from Rose. 

March 14, Charles SiunderH, living on Eist Mound street, was 
reported as havin^r small-pox. He was quarantined at home, and dis- 
charged March 31. Origin of the disease unknown. 

April 9, Dirk Evans, colored, was lound sick with small-pox at Dr. 
Evans' office, where he bad gone for tr« atment. He was removed to the 
pest house (a new, permanent structure haviog been built) the same day. 
He was discharged April 21. Origin of disease unknown. 

March 31, Charles McClusky and J^hn Benniiiger, inmates of St. 
Francis Hospital, were reported sick with small-pox and were removed 
to the pest house April 2. 

As these cases could not be attributable to exposure to the Rose 
case, removed from St. Francis February 25, it was evident that infection 
lingered in the hospital. I learned that the mattress upon which Rose 
had slept had probably been retained in the hospital, and had not been 
disinfected. The following cdmmunication was sent to Dr. Kinsmaji, 
health oSicer of Columbus: 



OHIO STATE BOARD OF HEALTH. M'J 

April 2, 1894. 
Dr. D. N. Kinsman, H. C, Columbus, Ohio: 

Dear Sir : I have been acquainted with the fact of a second outbreak of gmall-pox 
in St. Francis Hospital, and that a large number of inmates have been exposed to the 
disease. 

When the patient. Rose, suffering from small-pox, was taken from St. Francis some 
weeks ago other inmaiee who were exposed to him were confined to the hospital for but 
a^few days, and as a result one of them came down with small-pox in the city. 

I am reliably informed that the mattress on which Rose lay, while in St. Francis, 
was not destroyed, but was simply aired. There is also some doubt as to whether the 
clothing of Rose was destroyed. This suggests the probable origin of the ca^es just 
reported. 

I would strongly urge that all inmates, nurses, etc., be rigidly excluded from the 
public for not less than fourteen days from the time of last exposure, and would suggest 
that guards will probably be required to enforce this order. I would also urge that a 
trusted agent of your department be instructed to destroy all bedding and clothing 
used by the two small-pox patients. In this connection I beg respectfully to remind 
you that Rule 26 of the Rules and Regulations of the State Board of Health, makes 
it the duty of the health officer to immediately notify the Secretary of the existence 
of a case of small-pox, cholera, yellow fever or typhus fever occuring within his juris- 
diction. I have not, to this tinie, betn officially notified of the occurrence of smalJ-pox 
in Columbus. 

Respectfully, 

(Signed) C. O. Probst, Secretary. 

A conference followed this letter, and the hospital was quarantined 
with guards for fourteen days. The inmates were vaccinated by the 
health officer. 

April 16, Alice Terry, inmate of St. Francis, was reported sick with 
small pox, and was removed to the pest house about the 18th. The hos- 
pital was not again quarantined. 

The last case reported in Columbus was a student at the State Uni- 
versity named C. L. Mcllvaine. At the request of Dr. Kinsman, I saw 
the patient on the morning of May 30, at his boarding house on North 
High street, and pronounced the disease varioloid. The patient was re- 
moved to the small-pox hospital the same afternoon ; the inmates of the 
boarding house were vaccinated, and ordered by the health officer to 
remain in doors fourteen days. The patient had been vaccinated when a 
child and presented two faint scars. 

The patient, I learned, had left Columbus on Friday, May 25, and 
had gone to Cleveland, and from there to Geneva. He was taken sick the 
following day, and returned to Columbus on Tuesday, May 29, going on 
arrival direct to his boarding house. 

Some alarm was created over the matter at the University, which led 
to a large number of students being vaccinated. 

There were altogether eleven cases of small- pox in Columbus, with 
oae death. 



128 ANNUAL REPORT 

SPRINGFIELD. 

Saturday, January 20, a tramp from Chicago came to Springfield and 
stopped at a mission where he lodged till the following Monday. He was 
taken sick Sunday, and was sent to the general hospital Monday morning. 
On Wednesday the disease was pronounced small-pox. I was called there 
Thursday, the 25th, by the health officer; visited the patient and found 
him in the pustular stage of small-pox. I met the board of health, urged 
immediate vaccination of all expost d persons (this had been partially 
done) and the enforcement of vaccination of all school children. An order 
to this effect was adopted by the board on the 26th, and aleo a resolution 
urging all citizens to be vaccinated, and especially requesting proprietors 
of factories, shops, etc., to insist upon the vaccination of employes. The 
patient was removed to the infection hospital on the 26th. The inmates 
of the general hospital were quarantined fourteen days, and though many 
of them were intimately exposed to small-pox, none contracted the dis- 
ease. The patient recovered, and no other cases occured. 

SHELBY. 

January 30, Dr. I. A. Myers, of Shelby, wired a report of a case of 
small- pox four miles from that village. I telegraphed the township board 
to take charge of the case, giving instructions. The board had not been 
organized, but an organization was efJ'ectcd at once. All exposed persons 
were hunted up and vaccinated, and were held in quarantine fourteen 
days. I learned that the patient, Mrs. Mary Bloom, bad been in Cleve- 
land from January 9 to the 25th; source of exposure there unknown. 
She came to Shelby via the Big Four Railway on the 25th, and was sick 
at that time. She came in coach No. 27. Mr. Ingalls, president of the 
Big Four Railway, was requested on the 31st to have this car disin- 
fected at once. He replied, same date, saying it would be done immedi- 
ately. 

The patient had been staying at No. 321 Franklin avenue, Cleveland. 
Dr, Leick, health officer of Cleve'and, was so informed and reported that 
the family in which the patient had stayed and als > the neighbors had 
been ordered vaccinated. He telegraphed : "Woman had well marked 
rash when she left Cleveland. Advise as to quarantine." I advised 
quarantine ior fourteen days from last exposure, and this was enibrced. 

Fall instructions were given the township board (»f health for disin- 
fection, which was carried out on recovery o the patient. Nu othtr cases 
occurred. 



OHIO STATE BOARD OF HEALTH. 1 29 

TOLEDO. 

Small-pox was reported in Toledo February 6. The first case, Johni 
Wintermantle, was working in a factory on the corner of Superior and 
Oak streets when taken sick, and went immediately home, so there wac 
no great exposure, with the exception of the members of his family and 
three others. These were vaccinated and quarantined fourteen days., 
Origin of the disease unknown. 

The second case, Mr. 0. I. Ferrel, was reported February 7, and he 
was removed to the hospital on the Sth. This patient had been about for 
several days after the eruption appeared, and many people must have 
been exposed to him. On becoming more seriously ill he went to a 
brother's in Auburndale, where he was found. Origin of this case un- 
known. This family was vaccinated and quarantined. The father and 
son, who had been exposed, were taken to Auburndale, vaccinated and 
quarantined. A store and barber shop, in which the patient stayed, were 
fumigated. 

The son, D. .J. Ferrell, who was removed to Auburndale and quaran- 
tined there, developed small-pox February 20, having been vaccinated too 
late for protection. He was removed to the hospital on the 21st On this 
day, Thomas Barns, who, it was learned, had been exposed to the first 
Ferrell case, was reported ill. He was found in a doctor's office, suffering 
from small-pox at the time, and was removed to the hospital. Vaccina- 
tion and disinfection were carried out thoroughly in this case. 

The four cases all recovered, and were discharged from the hospital 
in March. 

April 9, another case of small-pox was reported. The patient, W. A. 
Gains, colored, had recently returned from California and Texas, coming 
via Chicago and Cincinnati. Origin of disease unknown. The healtfe 
officer reported that the patient was found lodging at 1607 Canton avenu^ 
" among a loose aggregation of his own color." They were vaccinated 
and quarantined. The patient was removed to the pest house. 

A man who, unknown to the authorities, had been exposed to thit 
case was sent to the workhouse and there developed small-pox. He wac 
removed to the hospital and the workhouse quarantined. An inmate of 
the Canton avenue house — Edward Bass — was vaccinated successfully, it 
is claimed, but fifteen days afterwards came down with small-pox. He 
was removed to the hospital where he died May 7. 

At this time men were engaged to enlarge the contagious disease hoa- 
pital. Care was taken to prevent the workmen from coming in contact 
with small-pox cases, but one of them contracted the disease. He wa§ 
taken to the hospital May 19, and died May 28 of hemorrhagic small-poi„ 

9 ST. B. H. 



130 ANNUAL REPORT 

On May 30, a tramp from Chicago was found with small-pox, and 
was taken to the hospital. He was' discharged June 23. No other cases 
have occurred in Toledo. 

There were in all nine cases in Toledo, and of these two died. 

LIMA. 

February 21, the health officer of Lima telegraphed, " One case vario- 
loid here, house quarantined." In answer to inquiry as to the origin and 
precautions taken, he wired, same date, " Toledo, probably ; am vaccina- 
ting all persons exposed." 

The patient, Harvey Neff, was a railroad engineer, running into 
Toledo. Domiciliary quarantine was instituted, and no other cases re- 
sulted. The patient recovered. 

The health officer of Toledo was notified that the case was suspected 
to be traceable to Toledo. The health officer of Lima could furnish no 
facts to support this conclusion, and the Toledo authorities were unable 
to trace exposure in that city. 

DAYTON. 

February 24, a man who had just completed a thirty-five days' sen- 
tence in the workhouse, was found suSering from what was supposed to 
be small-pox. The health officer reported that during his stay in the 
workhoase, another inmate had a similar eruption two weeks before the 
eruption appeared on Donnahue, the patient. The patient was sent back 
io the works, and the inmates vaccinated. The health officer subsequently 
reported that the disease was chicken-pox. No other cases of chicken-pox 
or small-pox developed. 

WORTHINGTON. 

March 11, I was called to Worthington, eight miles north of Colum- 
bus, by Dr. Johnson of that place, and asked to see a suspected case of 
small-pox near Worthington. 

The patient, Sarah Elison, had been sick for a week, and the township 
hoard of health had quarantined the house. The disease was probably 
gmall-pox, though the diagnosis was a little uncertain. I vaccinated the 
Inmates ,and sent word to the trustees to continue quarantine. 

The village authorities of Worthington organized a board of health, 
and quarantined two persons who had been exposed. Origin of the dis- 
ease unknown. No other cases resulted; the patient recovered. 

VINTON. 

March 18, a case of varioloid was reported near Vinton by Dr. Ham- 
ilton. The patient, George Eagle, who lived in Vinton, was taken sick at 



OHIO STATE BOARD OF HEALTH. I31 

his brother's in the country, in a house well isolated. The inmates were 
promptly vaccinated, and the physician established quarantine. The 
patient had been to Pittsburg two weeks before, and reported that the 
hotel in which he slept was across the street from a house from which a 
case of small-pox had been removed the day before he arrived. No other 
source of disease known. The patient recovered, and no other cases 
resulted. 

LORAIN. 

A telegram was received from Dr. Cox, health officer of Lorain, on 
April 3, reporting a case of small-pox in a tramp. In answer to a telegram 
for particulars he replied, "Probably two hundred exposed; tramp has 
been traveling between Sandusky and Fremont ; been in Lorain one 
week. Part of exposed people have been vaccinated. We have no pest 
house; tramp is in s n an ty belonging to railroad; have had orders to 
remove him and have no place to put him ; been sick nearly a week but 
had no doctor until last night. Answer at once." 

To this I replied that the board of health had authority to erect a 
pest house. He then wired to know what authority they had to seize 
land against the protest of owners. This brings up an interesting point. 
The statutes provide that the board of health may establish quarantine 
grounds, and nothing is eaid as to seizing land, except that any corpora- 
tion is authorized to purchase grounds for such purpose. 

This same question recently came up in Columbus. The building 
used for a pest houee was burned. When the second case of small-pox 
occurred the authorities decided to use a tent, and located it on the West 
Side, against the wishes of the people in that vicini y. Before the patient 
could be taken there they succeeded in getting a temporary injunction 
against it; but while hunting the health officer in order to serve the 
papers on him, the patient was placed in the tent, where he remained 
until a permanent pest house was built. 

I consulted the Attorney General in regard to the Lorain case, but 
he could find no authority in the statutes for peremptorily seizing land 
for a pest house. Going to the constitution of Ohio he found warrant 
for so doing "In time of war or other great public exigpncy." With his 
permission I telegraphed the health officer, as follows : "Attorney General 
holds under Section 19, Article 1, consti ution of Ohio, Board can seize 
and hold land for pest house within corporation. Act at once." 

On April 4, while in Cincinnati, a telegram was received from the 
health ofiicer of Lorain requesting me to come there at once. I left that 
night and reached Lorain the following afternoon. The patient had been 



132 ANNUAL REPORT 

removed to a pest house located at the edge of the village before I arrived. 
The owner of the land, however, notified the health officer that he would 
sue for $2,000 damages. The health officer desired a conference in regard 
to quarantine and other matters. 

The origin of the disease was unknown. The patient was found by 
the health officer in a switchman's house, and was then in a pustular 
stage. Twenty-one school children had been in or near this house, 
looking at the man. Fortunately they had all been vaccinated under the 
general vaccinnation order. It may be stated, parenthetically, that while 
there were many an ti- vaccinationists in Lorain when this order was being 
enforced, there were none at the time of my visit. The patient had slept 
a night or two in the water works pumping station, and the engineer had 
taken him home on one or two occasions to feed him. He was sick at 
the time. This family was quarantined, and also two other persons 
known to have been exposed. They were also vaccinated. The twenty- 
one school children were told to remain at home, but were not quaran- 
tined. I advised that they be examined daily by a physician from the 
eighth to the fourteenth day following exposure. This was arranged for. 
On the 16 h instant the health officer telegraphed that the engineer had 
developed varioloid. As he was quarantined at the time there were no 
additional exposures. Both patients recovered and no other cases 
developed. 

CLEVELAND. 

Six cases were reported in Cleveland during the year. Several 
attempts were made to obtain full reports of these cases from the health 
officer, but without avail. 

COLLINWOOD. 

June 24, a case of smallpox was reported at Collinwood. The patient 
was a child three years old named Ruth Bennett, who came to Collinwood 
with her parents on June 24, 1894. She was taken sick about June 19. 
The child and her parents spent one day in Chicago, June 8, and it is 
possible that she contracted small-pox in that city. The mother and 
father of the child contracted varioloid while in quarantine, the cases 
being exceedingly mild. All recovered. Proper measures for disinfec- 
tion were carried out and no other cases occurred. 

LUCKEY. 

On my way to Bryan, where I was called July 3, 1 stopped in Toledo 
and met Dr. Woods, the health officer. Dr. Woods had written to me a 
few days prior to this time, asking whether I deemed it wise for Toledo 



OHIO STATE BOARD OF HEALTH. 1 33 

to quarantine against Detroit on account of the prevalence of small-pox 
there. The day his letter was received, I telegraphed the health officer 
of Detroit for a report of the small-pox situation. He replied that they 
had twenty-six cases, all properly quarantined. I advised Dr. Woods by 
letter not to attempt to quarantine against Detroit, as Toledo's safety 
depended mainly upon what the Detroit authorities were doing to confine 
the disease.. Dr. Woods went to Detroit June 30. He reported to me 
that he found twenty-six cases of small-pox there, four deaths having 
occurred. He was well satisfied with the methods being taken to suppress 
the disease. 

He called my attention to a case of small-pox at Luckey, Ohio, and 
said his assistant had been to Luckey and reported that proper precautions 
were not being taken. I went to Luckey July 3, and met the attending 
physician, Dr. Peabody. With him I visited the patient and obtained 
the following history of the case : 

The patient, Henry McGale, came to Luckey from Lenawee, Michigan, 
June 7. He remained at the Merchant's Hotel in Detroit over night on 
either the 5th or 6th of June. On coming to Luckey he stayed with the 
family of Mr. McGin, who formerly lived in Lenawee. This family con- 
sisted of the father, mother and three small children. About ten days 
alter his arrival, McGale was taken sick. It being learned that a case of 
small-pox had occurred in the Merchant's Hotel about the time he was 
there, small-pox was suspected. The matter being reported to the Toledo 
health officer (Luckey is in Wood county near Toledo), Dr. Lyle, 
assistant health officer, was sent to examine the patient on June 22. He 
pronounced the disease measles. On the 25th of June, Dr. Peabody, of 
Luckey, was called in, and also the township health officer, Dr. Noble. 
The disease was diagnosed small-pox, and the patient was quarantined ; 
but the other inmates of the house were not strictly confined. Dr. Lyle 
saw the patient again June 30, and agreed that the disease was small-pox, 
but maintained that it was measles when he first saw the c^se. 

I crawled through an upstairs window and examined the patient. 
H,e presented a well marked case of small-pox, and had never been 
vaccinated. A male nurse Irom a neighboring house, a foreigner who. 
could not speak English, was with him. 

I then visited the three children of Mr. McGin, who were reported 
sick. They were all in bed, with marked symptoms of measles, the 
photophobia, excessive lachrymation, cough aiid typical rash of measles 
being present. Two of the children were taken sick June 30, and one on 
July 1. I saw them on the 3d. Upon close examination one child pre- 
sented about a dozen vesicles pointing through the measly rash. My 
diagnosis in this case was small-pox and measles. I was in doubt about 



134 ANNUAL REPORT 

other cases as to small-pox. The McGin family were all vaccinated on 
June 28, but unsuccessfully, with the exception of Mrs. McGin. 

In the afternoon I succeeded in getting a meeting of the township 
board of health, and they agreed to employ quarantine guards, fence up 
the public road passing the house, and hire Dr. Peabody to treat the 
cases. 

Returning from Bryan on the 5th, I again stopped at Luckey and 
visited the patients. The child found in the beginning of the vesicular 
stage of small-pox on the 3d was now covered with vesicles, some of them 
pustulating. The two other children, with the exception of slight cough 
and a roughened skin, were well. These children and their father were 
again vaccinated. I also attempted to vaccinate the family of the nurse, 
but was not permitted to do so, so they were quarantined. 

On July 18, Dr. Peabody reported that another, the second, McGin 
child had small-pox, and that the other one was having a high fever. On 
the 20th, the third child broke out with the disease. The vaccination 
was not successful, i. e., did not "take" with any but the mother. Two 
of the children had semi-confluent small-pox ; the other varioloid. All of 
the patients recovered. Quarantine was maintained the proper length of 
time, and until the house and its contents had been disinfected. 

I wrote to the secretary of the Michigan State Board of Health in 
regard to the case of small-pox reported at the Merchant's Hotel in 
Detroit, and he supplied the following information : ' " A female servant, 
named Leonard, was taken ill at the Merchant's Hotel in the city of De- 
troit, about the 25th of May, and the attending physician diagnosed the 
disease as measles. The health officer of the city was informed on June 
4, that a suspected case of small-pox was at that hotel. He called up the 
attending physician by telephone, and was answered in reply that the 
case was one of measles. The patient died June 6, and Thursday morn- 
ing (June 7) the health officer was requested to examine the body, which 
he did, and pronounced the cause of death small-pox." 

I reported to Dr. Baker the fact that McGale and one of the McGin 
children had both small-pox and measles at the same time, and in reply 
he said: "Your letter seems to confirm the allegation that the woman 
who died with small pox at the hotel in Detroit was also infected with 
measles. This last was claimed by the attending physician." 

The facts seem to indicate that McGale contracted both small-pox 
and measles from the case at the Merchant's Hotel, measles having devel- 
oped a few days prior to small-pox. The three McGin children contracted 
measles from McGale, and one of them both small-pox and measles, at 
the same time. The other McGin children probably contracted small- 
pox from the first child. 



OHIO STATE BOARD OF HEALTH. 13$ 

VACCINATION. 

At the meeting of the Board held in October, 1893, a rule was adopted 
requiring all school children to be successfully vaccinated. The order 
met with considerable opposition in many parts of the State, and a special 
meeting of the Board was held December 7, 1893, to consider the matter. 
At this meeting it was decided to postpone enforcement of the otder until 
after the Christmas holidays, i. e., to January 8, 1894. Subsequently, for 
reasons given below, the order was indefinitely suspended. 

The rule requiring the vaccination of school children was adopted by 
virtue of authority granted in an act passed March 14, 1893, which author- 
izes the State Board of Health to make orders and regulations for the 
prevention of contagious and infectious diseases, and requires local 
authorities to enforce such regulations. 

At the time of adopting the order there was every reason to fear that 
small-pox would prevail in this country to a wide extent, and Ohio was 
specially endangered by the prevalence of the disease in many localities 
in Pennsylvania, in Chicago, Illinois, and by its presence in the con- 
tiguous States of West Virginia, Kentucky and Indiana. One outbreak 
of the disease in Darke county, Ohio, which threatened the State oa 
account of the numerous exposures which had taken place before the 
State Board assumed control, had just been brought to a successful ter- 
mination, and a second outbreak had been reported in Ashtabula county. 

It was a fact well known to the Board that a comparatively small 
number of school children were vaccinated, except in communities where 
the boards of education had taken advantage of the law authorizing them 
to provide for vaccination of school children. Reports from health 
authorities of 315 cities, villages and townships, giving a school enroll- 
ment ot 116,966, show that in the territory represented but 24,224, or 
nineteen per cent, of the school children, were vaccinated prior to 1893. 

A iew weeks after issuing the order notice was received from several 
of the boards of health of important cities that their legal advisors had 
instructed them to not enforce the order. About this time considerable 
opposition was manifested by the school authorities, the chief alleged 
objection being the interference with school attendance and consequent 
interruption of examinations to be held just prior to the holidays. 

It was to have been expected that considerable opposition to vaccina- 
tion would be encountered, but probably the Board was unprepared for 
so general a refusal to comply with the order. Especially was this met 
with in the rural districts. Unfortunately the township boards of educa- 
tion in many townships opposed the order, and as they were often sup- 
ported by the people, township boards of health were at a loss to know 



136 ANNUAL REPORT 

how to proceed. The only means provide 1 for enforcing vaccination was 
by calling to aid the truant law. But in many school districts pupils by 
January 8, 1894, had already attended school the full time required by 
law, so that in such case to enforce the order was to close the school, and 
still not secure vaccination of the scholars. Several schools were in fact 
closed rather than submit to vaccination, and the township health 
authorities were involved in many quarrels with neighbors and school 
authorities. The Board was flooded with letters in opposition to the 
©rder, and with petitions to have it suspended. 

From these conditions arose one of the most serious difficulties en- 
sountered in attempting to enforce general vaccination of school children ; 
ihe very existence of our township boards of health was placed in jeop- 
ardy. The State Board had special reason to congratulate itself on hav- 
ing secured the establishment of boards of health for rural districts. In 
considerably less than a year's time over one thousand township boards 
of health were established and fully organized for health work. Their 
(Sfiorts in preventing spread of infectious diseases were fast gaining public 
approbation, and the time seemed near at hand when we could point to 
an effective board of health in each town and township in the State. The 
wave of opposition against vaccination in the townships, where, it was 
urged by the people, small-pox was unlikely to occur, threatened, how- 
ever, to wipe out a thousand boards of health and undo all that had been 
accomplished in rural sanitation. 

On the meeting of Legislature a Representative called at the office 
and said that never since war times had he known greater excitement 
tlj^n prevailed in his county over the vaccination order. Indignation 
meetings, he stated, had been held in every township, and he had been 
burned in effigy for voting for the bill to establish township boards of 
health and to give the State Board such powers. Another Representative 
called and said he had prepared a bill to abolish the township boards of 
health. Although his reason for introducing the bill was not stated to be 
on account of the vaccination order, it is highly probable that a bill of 
this character would have been passed bad the vaccination order not 
been suspended. 

A further reason for temporarily suspending vaccination arose from 
the increasing prevalence of la grippe during the month of December. 
Following the meeting of the Board on the 7th, letters and petitions from 
many sections of the State were received, requesting permission to post- 
pone vaccination for a time on account of local enemies of this disease. 
Not deeming it advisable to vaccinate, and especially to enforce vaccina- 
tion during the prevalence of an epidemic disease, requests of that charac- 
ter were granted. 



OHIO STATE BOARD OF HEALTH. 137 

On turning to our monthly reports for indications of increasing prev- 
alence of this disease, we find a marked extension in December as com- 
pared with the previous month, especially if the increased mortality from 
pneumonia, which is, with great probability, largely attributable to la 
grippe, be taken into consideration. During November, 1893, in a popula- 
tion of 1,387,258, there were reported fifteen deaths from la grippe and 228 
deaths from pneumonia. During December, 1893, in a population of 
1,352,827, there were reported 144 deaths from la grippe and 412 deaths 
from pneumonia, being an increase of 129 deaths from la grippe and 184 
from pneumonia, as compared with the previous month. Compared 
with December, 1892, when influenza was not prevailing, there were re- 
ported in a population of 1,327,745, no deaths from that disease and but 
186 deaths from pneumonia, showing an excess of 212 deaths from the 
latter disease. 

The population represented in the reports for December is, roughly, 
one-third of the entire population of the State, and chiefly an urban popu- 
lation. Reports from rural districts indicate that la grippe has been 
equally prevalent there. If it be assumed that the mortality was propor- 
tionately equal throughout the State, there were in December, 1893, no 
fewer than 434 deaths from la grippe and 1,236 deaths from pneumonia, 
in part chargeable to the former disease. 

The fact, generally observed, that the rate of mortality from la grippe 
has been unusually small this year, should be taken into consideration 
in judging of the prevalence of the disease from the number of deaths 
reported. 

It may be of interest for future reference to briefly note the principal 
reasons urged in opposition to compulsory vaccination of school children. 
We may dismiss the opposition of anti-vaccinationists, which will always 
be encountered, except to note the fact that a limited number of physi- 
cians may be found in our State who oppose it, and acquire a following 
of all those who resist vaccination, from whatever cause. 

There is unfortunately some room for conflict of authority on account 
of the statutes authorizing both boards of health and boards of education 
to enforce vaccination. There is, in fact, no expres authority granted to 
boards of health to enforce vaccination ; tJiey must act under the general 
provision authorizing them to make and enforce regulations for the pre- 
vention of disease. On the contrary, boards of education are directly 
authorized to provide for and require vaccination of school children. 
Boards of education were greatly averse to having schools interrupted, 
and in very many places, and especially in the townships, were opposed 
to vaccination at any time. It was urged that as Legislature had left the 
matter of vaccination of school children to the option of the boards of 



138 ANNUAL REPORT 

education, boards of health had no authority to interfere except in the 
presence of small-pox. This was a most prolific source of trouble and 
opposition to the Board's vaccination order. 

The objection most frequently raised against vaccination by indi- 
viduals, as well as by many health authorities, was that the cold season 
of the year is an unfavorable time for the operation on account of serious 
complications being more apt to arise. While there is probably not 
much ground for this belief, the opposition it aroused against the vacci- 
nation order seriously interfered with its enforcement. Scores of letters 
were received from boards of health and individuals, promising that the 
vaccination order would be complied with in the spring, but expressing 
a determination to resist vaccination during the cold weather. From 
some cause it appears that the vaccine disease has been more severe this 
year than usual. Many reports of deaths from vaccination were pub- 
lished in the papers. These were all inquired into by me; and while 
they proved to be false, they caused a general excitement which official 
contradiction could not allay. A remarkably large number of cases of 
vaccine eruption were reported ; and in one such case the attending phy- 
sician maintained that the disease was small-pox, due to vaccination, and 
the case was treated as such, and quarantined by the township health 
authorities. Reports of these cases, published in the papers, created 
much alarm and increased the opposition to vaccination. 

The financial depression was another obstacle to vaccination that 
should be noted. To those of us familiar with the cost of small-pox epi- 
demics, this objection is more than groundless ; for it is probable that the 
one epidemic in Akron of a year ago caused a financial loss sufficient to 
have met the expense of vaccinating all the school children in the State ; 
and vaccination may justly be looked upon as insurance against such 
losses. This year, however, and especially during the la-t two months, 
thousands of laboring men have been out of employment. The majority of 
such men shrink from relief from the pauper fund as long as possible ; and 
as public authorities are only justified in providing vaccination for the poor, 
hundreds of unemployed opposed the order because they were unable to 
bear the expense and too proud to have it paid out of the poor fund. 

The suspension order caused some misunderstanding on the part of local 
authorities. The order was intended to give relief to the township boards of 
health, and at the same time allow local health authorities of cities and vil- 
lages, or of townships where the order has been locally adopted and pub- 
lished to tostillenforceit.ifconditionsjustified. In some places this was done, 
but in some others it was claimed that vaccination was defeated by the 
suspension of the order. The foregoing will have made it clear that, hav- 



OHIO STATE BOARD OF HEALTH. 1 39 

ing the sanitary interests of the whole State in view, no other action 
could have been taken by this Board. 

An attempt was made to secure from each board of health a report 
of the school enrollment, the number vaccinated prior to 1893, and the 
number vaccinated during 1893. A large number failed to report, but 
the following table will show that in spite of opposition many thousands 
of school children were vaccinated under the Board's order : 

166 Cities and Villages. 

Enrollment 84,598 

Vaccinated priorto 1893 20,138 249^, 

Vaccinated in 1893 33,567 40^ 

^:^Un vaccinated.. 30,893 SH 

149 Townships. 

Enrolled 41,771 

Vaccinated prior to 1893 4,086 9+^ 

Vaccinated in 1893 11,720 28-^^ 

Unvaccinated 25,965 629^, 



INSPECTION OF NATIONAL VACCINE ESTABLISHMENT. 

Washington, D. C. 

Mr. President : Your eommittee, on the establishment of a vaccine farm, on 
May 13, inspected the National Vaccine Establishment at Washington, D. C. Dr. Stan- 
ton, a member of the committee, was, at the last moment, prevented from going. Dr. 
Kinyoun, bacteriologist of the Marine Hospital Service, stationed at present at Waeh- 
ington, accompanied us. 

We are under many oblia:ation8 to Dr. Walsh, manager of the establishment, for 
the pains taken to give us the best possible opportunity for witnessing methods used 
there in propagating vaccine virus. 

The farm consists of ten acres located some seven or e'ght miles from Washington, 
on a line of electric railway. There is on it a commodious dwelling in which Dr. 
Walsh and family live for a part of the year, and the stables in which vaccinated 
animals are kept. These are neat and plain wooden buildings, kept whitewashed. 

The vaccine seed now used was obtained from the New York City vaccine 
farm. Animals for vaccination were formerly rented, but are now purchased by Dr. 
Walsh. After use they are sold for food or any other purpose. Calves from one to 
three years old are used. 

Vaccination is performed on the back, the scarification commencing a few inches in 
front of the root of the tail. Patches of skin, about eight inches long and four inches 
wide, on both sides of the spinal column, are shaved clean and washed with clean water, 
soap, and balls of absorbent cotton. A knife with five parallel blades is used for 
making the incisions. These are quite deep as compared with the incisions made in 
human vaccination, and considerable blood is drawn. Vaccination is performed with 
what are known as " teed spades." These are large ivory points charged with the lymph 
first taken from the calf. 



140 ANNUAL REPORT 

As a rule a calf is vaecinated at the time lymph is being taken from another calf. 
In from four, five to seven days after vaccinating, depending partly on the atmospheric 
temperature, the lymph is collected. At this time the site of vaccination is covered 
with a thin scab. This is scraped ofi^ with a piece of ivory having a blunt edge, until a 
clean oozing surface is reached. Clean water and balls of absorbent cotton are used in 
the cleaning. A row of ivory points, twenty or more in number, are fastened between 
two pieces of wood, leaving the points presenting. 

The oozing lymph is taken up with a camels-hair brush, and brushed over the 
points. These are placed in a tin box wiih acover, where they are allowed to dry. These 
points are in reality ivory, and not bone as often supposed, and the pointed or charged 
end is never handled. 

The stables and surroundings were found scrupulously clean. The animals on 
hand for vaccination were in good condition and apparently healthy. 

Dr. Kinyoun made three suggestions which Dr. Walsh expressed the intention of 
adopting, viz. : 

1st. Testing all animals for tuberculosis by tuberculin. 

2d. Sterilizing points by heat before charging them, and 

3d. Covering vaccinated surface with Collodion for protection against inoculation 
by flies. Although the stables were as efTectually screened as could be, it was impossible 
to keep out all flies. 

With reppect to establishing a vaccine farm in connection with the Ohio State 
University, your committee is of the opinion that it would not be wise to urge that this 
be done in the near future. Neither is your committee in favor of keeping on hand a 
large supply of virus to be sold to local authorities and physicians. It is believed 
so doing would arouse the active opposition of the drug trade, and cause an endless 
amount of work and annoyance in supplying small orders, collecting bills, etc. 

We therefore recommend that the plan adopted by the Board for the past six years 
be continued, viz.: To keep on hand a small amount of reliable vaccine virus to be furn- 
ished free, on an outbreak of small-pox, for the vaccination only of persons who have 
been actually exposed to the disease. 

Respectfully submitted. 

(Signed) Thos. C. Hoover, 

C. O. Probst. 



INSPECTION OF THE NATIONAL WOMAN'S RELIEF CORPS 
HOME, AT MADISON, LAKE COUNTY. 

BY THE SECRETARY. 

A letter was received from the secretary of the National Woman's 
Relief Corps Home, stating that there was fear that the water supply of 
the Home was subject to pollution; that the Board of Managers, by the 
advice of the Representative from Lake county, had instructed the secre- 
tary to request me to come and make an investigation in order that 
changes in water supply or sewerage, if required, might be properly 
made. Accordingly, I visited the Home on June 19, and was met by 
the secretary, Mrs. Pluma L. Cowles, of Geneva. On returning I made 
the following report of my investigation : « 



OHIO STATE BOARD OF HEALTH. I4I 

Ohio State Eoakd of Health, 

Secretary's Office, 
Columbus, Ohio, June 22, 1894. 
Mrs. Pluma L CowlES, Secretary N. W. R. G. Home : 

Dear Madam : On June 19, at your request, I made an inspection of the 
National Woman's Relief Corps Home, at Madison, Ohio, and beg leave to submit the 
following report : 

Permit me to say first that I was much pleased with the institution and the manner 
in which it is conducied. No eft'urt seems to have been spared, in the arrangement and 
furnishing of the building, to secure the comfort of the inmates, and the visitor is im- 
pressed with the fact that he is in a well ordered home. 

The sanitary features of the Home are excellent, with the possible exception of the 
water supply. This is laken from a dug well thirty-five feet deep, located a short dis- 
tance north of the buildin/, the water being pumped to the tanks in the attio by wind- 
mill. The drainage from the biilding, which includes water from the water closet, 
laundry and kitchen, and a considerable part of the roof water, is conducted through a 
pipe drain to a cess-pool located about 200 feet north of the building, and 120 feet 
northeast of the well It is nine or ten feet deep ; walled with rock uncemented, so as 
to leach freely into the soil. The so'l is sand and gravel with a slight lajer of clay 
beneath, which is pierced by the well. 

It is possible, as a large amount of water is pumped from the well, that its circle of 
drainage may at times extend nearly, if not quite to the cess-pool, and I would therefore 
strongly urge that this cess-pool be cleaned, filled and abandoned. Without great ex- 
pense the house drain may be extended directly north for a distance of 125 feet, and a 
new cess-pool be constructed on the plan of the old one, at its terminus. At that dis- 
tance from the well, practically 250 feet — there will be no danger of pollution of the 
water supply from that source. Great care should be taken to secure an absolutely 
water-tight drain ; and I would caution you, that unless the drain pipes are properly 
bedded there is danger of joints being broken by the settling earth. 

I should perhaps call attention to the fact that the east and west partition walls 
seem to be imp&rfectly supported. While I do not consider the walls to be in a danger- 
ous condition, I would advise that you call upon the Inspector of Workshops and Fac- 
tories to examine them and suggest means for increasing their foundation support. 

Very respectfully, 

(Signed) C. O. Probst, Secretary. 



REPORT ON THE SANITARY CONDITION OF EAST PALESTINE. 

BY THE SECRETARY. 

The board of health of East Palestine reported that the village was 
in bad a sanitary condition, owing to the neglect of council to provide 
adequate drainage facilities, and requested me to come there with a view 
of enabling the board to secure needed improvements. 

As East Palestine is near Alliance I was able to visit both places with- 
out much increased expense or loss of time. I was piloted over the village 
by the health officer, accompanied b}' members of the board of health. 
On my return I made the following report to the board of health, and by 
them it was transmitted to council : 



142 ANNUAL REPORT 

Ohio State Board of Health, 
Office of the Secretary, Columbus, O. 

To the Board of Health, East Falestine, Ohio: 

Dear Sir : On the 11th of July, at the request of your board, I made an iuspection 
of the sanitary condition of your village, and would respectfully report as follows: 

I desire first to congratulate your village on having provided a public supply of 
pure water. Its use should be encouraged, as the water in your wells, owing to the fact 
that leaching privy vaults are everywhere allowed, is much less likely to be pure and 
wholesome. As your public water supply is derived from ground water great care should 
be taken to protect it from pollution arising from contamination of the soil in the neigh- 
borhood of the public well. In this connection attention should be called to the pollu- 
tion of Leslie's run. This stream flows within a short distance of the well from which 
the public supply is pumped, and there is a possibility that contamination of the stream 
will contaminate the water supply. The banks of the run are being used ae a public 
dumping ground, and a slaughter house is situated on the run a short distance above the 
pumping station. All pollution of this stream should be stopped; that which occurs 
within the corporation, by the board of health; pollution outside should be stopped by 
the corporation, as provided in Section 2433 of the Kevised Statutes. 

While a public supply of pure water is a blessing to any community, it may be indirectly 
the cause of a nuisance, and detrimental to health. The introduction of a public water 
supply always leads to a greatly increased amount of foul water to be disposed of, and 
sewerage becomes necessary. Where drains have already been provided to carry ofi 
storm water it invariably happens that these are iised by an ever increasing number of 
persons to carry off household wastes. As rainfalls ate depended upon to flush them, 
the contents of these drains decompose between storms', and noxious oHors pervade the 
streets and houses. As soon as passible, therefore, your village should be provided with 
an adequate system of sewerage. Fortunately the topography is such as to allow a 
ready escape of storm water, so that in introducing sewerage the "separate system," i. e., 
small pipe sewsrs used exclusively for household drainage, will suffice. This is very 
much cheaper than the " combined system," where both storm water and sewage have to 
be cared for. 

At the present time the failure to provide mean*! for surface drainage is causing 
most trouble. Lake run, which fl >ws through the village, receives most of the surface 
filth, which is washed into it by rains, and in addition the drainage from a considerable 
number of houses. This ran is obstructed by rocks and bolder- and v; rious kinds of 
refuse thrown into it. Stagnant pools are formed, which give ofl bad odors, creating a 
nuisance at many points. Without great expense a smooth open drain could be con- 
structed in this run which would rapidly carry off its ordinary flow. Household drain- 
age brought to the run should be carried to this open drain so that it would be quickly 
removed. By this improvement, and by keeping other kinds of filth out of it, this source 
of nuisance could be removed. 

House drainage being carried into the street gutters, without proper provision for 
its free escape, is another source of nuisance. These gutters are in many places obstructed 
by a growth of grats and weeds, and by stones and street washings, so that foul slops are 
retained, to decompose and load the atmosphere with bad odors. This should be remedied 
by having smooth gutters, made of brick, or better, of half sections of sewer pipe. Until 
a sewerage system )s introduced it will be much better to carry off household wastes by 
these smooth gutters, than to run it into underground drains which cannot be flushed 
except by storms. 

One specially bad place exists near the depot, where a storm sewer, which carries a 
considerable amount of house drainage, empties into an open ditch. The bad odors at 
this point are plainly perceptible to passengers on stopping trains, and would certainly 
not invite one to take up a residence in your village. 



OHIO STATE BOARD OF HEALTH. 1 43 

You are aware that all matters of sewerage and drainage are placed by law in the 
hands of council, so that your board will have performed its whole duty by calling the 
attention of council to the unsanitary conditions arising from their neglect. 

It is to be hoped that your citizens, recogoizing the necessity for improved drainage, 
will urge council to provide, at no distant day, a complete system of sewerage. 

Respectfully, 

(Signed) C O. Pkobst, Secretary. 



REPORT ON THE SANITARY CONDITION OF UHRICHSVILLE. 

BY THE SECRETARY. 

Dr. McCoUam, of Uhrichsville, a member of the local board of health, 
reported that sanitary matters were at a low ebb in the village, and that 
the members of the board proposed to resign unless something could be 
done. He stated that the principal difficulty was that the mayor, from 
timidity or policy, would not sustain the board in enforcing its orders. 
I was urged to pay them a visit, which I did May Slst. I was met by 
Dr. McCollam and Mr. Stout, members of the board, and Dr. Groves, health 
officer, and we spent the afternoon viewing the village and its water 
works. 

Uhrichsville is a town of about 4,000 inhabitants, located on the 
Pennsylvania and the C, L. & W. railroads. It is continuous with Den- 
nison, a town of about 3,500 inhabitants. The towns are in a rather 
narrow valley surrounded by;, high hills. Light and water are furnished 
to both by the same plants. Water is obtained from big Stillwater creek, 
the pumping station being located more than a mile from either town. 
This stream does not receive drainage from any town above the intake, 
and would seem to afford a fairly good water supply, except that the water 
is very muddy in time of floods. Water is pumped to a reservoir on the 
top ot a high hill and is delivered by gravit)^ 

Only about one-tenth, estimated, of the population of Uhrichsville 
use the public supply, the balance depending on wells ; and as no precau- 
tions are taken to guard against privy vault pollution, many of them 
furnish bad water. 

No reports are made of cases oi typhoid lever, but Drs. Groves and 
McCollam were able to count some seventy cases as having occurred dur- 
ing the past year, with six deaths. 

A meeting of the board of health was held in the evening. I found 
that the board had properly adopted and published rules and regulations 
which, if enforced, would guarantee a good sanitary condition of the town. 
As I informed the members, they had a most excellent health organiza- 
tion — on paper. The board is composed of good men, and they have 



144 ANNUAL REPORT 

accomplished considerable good, but in a number of instances they had 
allowed their orders to be set at defiance. Some of their physicians refused 
to report contagious diseases. The mayor in one or two instances had 
refused to issue a warrant for the arrest of persons violating their orders. 

The matter of the board's powers and duties was fully entered into. 
The steps to be taken to abate nuisances were fully explained. The 
mayor's position in refusing to issue a warrant, and the means to be taken 
to compel him to perform this duty, were also discussed. I should say 
that the mayor showed no hostility, but on the contrary, seemed desirous 
to carry out all necessary sanitary measures. 

I learned that in many years' work of the board no person had ever 
been prosecuted for failure to comply with its orders ; and I advised that 
such an example be made at the firtt opportunity, selecting a case where 
some man of influence was at fault. It was stated that several of their 
well-to-do citizens had made light of the board's orders and defied the 
board to enforce them. 

My visit, as one of the members expressed it, stiflFened the back bone 
of the board, and the members expressed the determination to strictly 
enforce their rules and regulations. 

The following is a copy of a report on the chemical examination of 
the water supply for Uhrichsville, furnished by the health officer: 

Sample taken from hydrant at Healea & Green's office, June 25, 1894. 

GENERAL CHAJRACTEB. 

Sample moderately clear, after filtration perfectly clear, without color, odor or taste. 
The reaction exhibited the presence of free carbonic acid. 

COMPOSITION. 

The following examinations, except those for nitrogen, were made with filtered water, 
and relates therefore to matters held in solution. These are as follows : 

Total solid matter in solution, 82.25 parts in one million parts of water, or about 
4.77 grains per gallon. 

Silica, 11 parts in one million parts of water, or about 638 grains per gallon. 

Iron and aluminum oxides, 4 par;s in one million partH of water, or about 0.232 
grains per gallon. 

Calcium, 42 parts in one million parts of water, or about 2.43 grains per gallon. 

Magnesium, 11 parts in one million parts of water, or about 0.638 gr ins per gallon. 

Sulphur as 80*, 23 parts in one million parts of water, or about 1.33 grains per 
gallon. 

Chlorine, 5.65 parts in one million parts of water, or about 0.327 grains per gallon. 

Sodium, by diflference, 12 parts in one million parts of water, or about 0.696 grains 
per gallon. 

Temporary hardness equivalent to 146 parts of ca'cium carbonate in one million 
parts of water, or about 8.468 grains per gallon. 

Permanent hardness equivalent to about 6 parts of calcium carbonate in one mil- 
lion parts of water, or about 0.348 grains per gallon. 



OHIO STATE BOARD OF HEALTH. 1 45 

Nitrogen present as ammonium compounds .000026 part in one million parts of 
water. 

Nitrogen present in organic combination .000176 part in one million parts of water. 

Phosphates, traces. 

Nitrates, traces. 

CO^, both free and combined, 87 parts in one million parts of water, or about 5 
grains per gallon. 

Dissolved oxygen, at 60 degrees F. and 760 mm, 8.94 parts in one million parts of 
water, or about 0.518 grains per gallon. 

DISCUSSION. 

An examination of the above analytical results shows the following facts : 

1. The total ajQount of dissolved solids is quite low, much less than is generally 
found in deep well waters ; the water, therefore, is available for mechanical and manu- 
facturing purposes, generally, to a much greater extent than is the case with waters 
obtained from wells. 

2. The low amount of solids, and especially the sulphate of lime, indicates that 
when used as a boiler water, the deposits will be in the form of a soft sludge easily 
gotten rid of by blowing oflf. 

3. The very low amount of organic matters indicates that the water is quite free 
from injurious sewage contamination. A feature worthy of especial mention, shown by 
this and a fcrmer analysis, is that of the organic matter present; the major portion is 
suspended instead of being diss^olved, and hence may be removed by simple filtration 
through a bed of sand or other cheap filtering material. In this respect it is much to 
be preferred to those waters which, though clear and sparkling in appearance, contain 
dissolved large amounts of organic matter incapable of being removed by filtration. 

As far as a chemical analysis is capable of indicating, the water, especially if 
subjected to filtration, may be regarded as possessing every quality necessary in a water 
designed for general public use. 

1. The low amount of dissolved solids, and the presence of considerable dissolved 
oxygen and carbonic acid indicate that the water may possibly attack the iron of boilers 
in which it is used, but this fact can be certainly determined only by actual trial. 

(Signed" J. H. Beal, J.na/2/s^ 



REPORT OX THE SANITARY CONDITION OF SCHOOL HOUSE 

AT BRYAN. 

BY THE SECRETARY. 

On July 4, at the request of the board of health and board of educa- 
tion, Williams county, I examined one of their school buildings to 
determine its sanitary condition, which had been questioned by some of 
the citizens. 

The mayor, health officer and members of the board of health and" 
board of education accompanied and aided me in the investigation. 

The building is of brick, two stories high, has no basement, and was 
constructed earl}^ in the sixties. There are two Irooms down stairs and 
two up, only one of the upper rooms being used. 

10 ST. B. H. 



146 ANNUAL REPORT 

The window epace for lighting is ample and properly placed. Black- 
boards at the sides of the rooms are placed between windows, and when 
used by teachers for class or general instruction must be hurtful to pupils' 
eyes. 

Heating is accomplished by stoves made to burn wood. 

The rooms are ventilated by windows, a strip of wood being placed 
under the lower sash of each window. A year or two ago, to improve the 
ventilation, tin pipes about eight inches in diameter were placed in two 
corners of each lower room. The pipes reach nearly to the floor, and are 
open at their lower and upper ends. On one side of the building these 
pipes extend to the attic, which is closed, however, passing through the 
school-room above but having no connection with it. On the other side 
the pipes open into the room above, which is not used. Ventilators are 
placed in the ceilings of both lower rooms. 

Complaints had been made that the building is damp. The janitor 
admitted that the walls of the lower rooms are at times, though very 
rarely, covered with moisture. I can account for this only by supposing 
it to be due to the condensation of the aqueous vapor of the atmosphere. 
The foundation walls are protected against dampness by the grounds 
having been graded to carry the rainfall away, and by drains to carry off 
roof water collected by the eaves. 

Complaints had been made to the local authorities that many of the 
children who attended school in this building sufter from headache, but 
on inquiry it appeared that complaints were as frequent regarding 
children who attended school at the new building, in which the Smead 
system of heating and ventilation is used. 

On the whole it may be said that the old school building is in fairly 
good sanitary condition. 

Improvements can be made in its ventilation, and at small cost, and 
I recommend the following changes : 

Enclose the stoves with tight sheet-iron jackets fastened to the floor 
and extended two or three feet above the stoves. Make an opening in the 
floor under the stove and connect it with a tight wooden or sheet-iron 
<conduit extending under the floor to the open air. A considerable volume 
of fresh, partly warmed air can be introduced into the rooms in this 
manner. During school hours lighted lamps should be placed in the tin 
pipes in the corners of the roonirs. These pipes should be carried to the 
attic on both sides, and the attic should have an opening for the escape 
of loul air. The upper room should have independent pipes carried to 
the attic, with burning lamps in them, the same as for lower rooms. 
The stove should be jacketed and a fresh air conduit constructed between 



OHIO STATE BOARD OF HEALTH. 1 47 

the floor of the upper and ceiling of the lower room. This arrangement, 
with watchfulness of the windows, will secure a fairly good ventilation. 

I also inspected the new school building, which was constructed a 
few years ago. No complaint has been made of this building since stoves, 
which are kept burning during school hours, were placed in the ventilating 
stacks. 

The only fault to be found with the building is the location of black- 
boards. All of these are between windows, and a strong glare of light is 
met by many of the pupils in reading work on boards at sides of rooms. 
This evil is aggravated by there being no recitation benches from which 
pupils might look in a favorable direction, and by the use of " dustless 
crayons," a kind of soapstone which gives grayish, indistinct marks. All 
of those present during our investigation, complained of painful vision on 
attempting to read sentences written on certain of the blackboards, and a 
few were unable to read the sentences at all from across the room. 

I was informed that it is a matter of common observation that an 
unusually large number of school children are troubled with defective 
vision, and certainly the conditions exist to produce it. No proper 
inquiry has been made as to the condition of the pupils' eyes, or the num- 
ber affected, and I would advise that a competent man be employed to 
examine into this. I would also advise that crayons producing a pure 
white mark be used on blackboards. Blackboards in an unfavorable 
condition should not be used for general school work. For this purpose 
it would be much better to have blackboards placed at the ends of the 
rooms, facing the scholars. 

Respectfully submitted. 

(Signed) C. O. Probst, Secretary. 

Under date of October 21, Mr. N. Vineyard, the health ojaicer of Bryan, 
writes: "The board of trustees have repaired the Butler street school 
building just as you recommended ; and there seems to be good satisfac- 
tion rendered. Mr. Gillis, member of the board, told me that they carried 
out your suggestions to a dot." 



REPORT OF DELEGATE 

TO THE MONTREAL MEETING OF THE AMERICAN PUBLIC HEALTH ASSOCIATION. 

The twenty-second annual meeting of the American Public Health 
Association was held in Montreal, Canada, September 25-28, 1894. The 
meeting was well attended, about 250 members being present. 



148 ANNUAL REPORT 

A few valuable papers were presented. A group of papers, bearing 
upon water supplies and their purification, were of very great interest. 
Among the most important of these was the report of the committee on 
the pollution of water supplies, presented by Dr. Charles Smart of the 
United States Army. 

This committee, in its report presented at the Milwaukee meeting, in 
1888, took the position that a water polluted with sewage cannot be safely 
used as a public water supply, as the means ordinarily used for purifying 
public supplies cannot be depended upon for the removal of typhoid fever 
germs, if these are present in the water. This year the committee receded 
from that position in view ot what has since been shown can be done in 
removing bacteria by filtration through sand. 

Filtration as carried out at Lawrence, Mass, and at Poughkeepsie, 
Hudson, Ilion, and Mt. Vernon, New York, shows that 98 per cent, ot the 
bacteria can be removed, and that the typhoid fever death rate in these cities 
was reduced, by filtration of water, from 127 to 24 annually per 100,000. 
The committee pointed out that the work in water bacteria was in some- 
what chaotic condition, and suggested an arrangement for co-operative 
work by which the different forms of water bacteria could be separately 
studied at different laboratories; one for instance taking up the intestinal 
bacteria, another the vibrios, and so on. 

In line with this suggestion, and at the request of Dr. Smart, I intro- 
duced the following resolution, which was adopted : 

Revived, "That this Association approves the suggestion of the co-operative investi- 
gation into the bacteriology of water, and commends the eflibrts of the committee in 
carrying out this work to officers of State and Municipal boards of health, to the indi- 
vidual members of this Association, and to all persons interested in the purity of water 
supplies, for such special assistance as they may be able to render.'' 

The executive committee subsequently made the committee a grant 
of $200, for preliminary work. In this connection a matter of interest 
may be stated. After the meeting Dr. Smart went to New York city with 
Dr. Ferguson of that city, for the purpose of soliciting financial aid for the 
committee from some of the Life Insurance companies. The president of the 
New York Life Insurance Company had told Dr. Ferguson that his com- 
pany would be willing to contribute towards scientific sanitary investiga- 
tion, which would likely result in lowering the death rate of their policy 
holders. I have not yet learned whether contributions were received, 
but I consider that this woald be a most valuable precedent, showing the 
financial interests at stake in work of this character. 

Another paper, in this water group, of interest, was presented by Mr. 
Fuller, who is in charge of the bacteriological work at the Lawrence Experi- 



OHIO STATE BOARD OF HEALTH. 1 49 

ment Station. The city of Lawrence a year ago established filters for the pub- 
lic water supply. The bacteria of the Merrimac river were reduced by 
filtration from about 9,000 to 150 per c. c, or over ninety-eight per cent. 
During the five years preceding the use of the filter the average annual 
death rate from typhoid fever was 127 per 100,000 inhabitants, while 
during the past year, filtered water being supplied, the rate was but fifty- 
two per 100,000, a reduction of about sixty per cent. Furthermore, nearly 
one-half of the deaths were among mill operatives who did not drink the 
filtered water. This is the more interesting because the city of Lowell, 
only a few miles above Lawrence on the Merrimac, suffered severely dur- 
ing the year from typhoid fever; and it has been shown in former reports 
that an increase in typhoid fever in Lowell heretofore has been usually 
followed by an increase in the disease at Lawrence. 

At the close of the discussion of these papers the following resolution, 
presented by Dr Gardiner, of Ontario, was adopted : 

Resolved, " Ihat in view of the danger to the public health hj the contamination of 
our fresh water lakes, rivers and streams, that this association memorialize the different 
Federal governments as well as the State and Provincial governments, to pass laws 
prohibiting the contamination of these water supplies by sewage from cities, towns and 
villages, and compel them to provide some means for the treatment and oxidization of 
this sewage before emptying it into these places." 

Some interesting papers were presented on diphtheria ; one of value 
was that by Dr. Bryce, of Ontario, on "Practical DiflBculties of Medical 
Health Officers and Physicians in Dealing with Suspected Cases of Diph- 
theria." A point of practical importance brought out in this paper was 
the necessity for bacteriological examination to establish the diagnosis of 
diphtheria, and the practical impossibilities of having this done in most 
oases. The author urged that at present health officers should use pre- 
ventive measures in all cases of membranous sore throat. It might also 
be pointed out in this connection that it will now be difficult, or im. 
possible, to enforce the law requiring reports of diphtheria cases unless 
the diagnosis is made certain by bacteriological examination. 

Dr. Nagle, Registrar of Vital Statistics of New York City, presented 
a report on the Antitoxin treatment of diphtheria. 

Several papers on tuberculosis were presented. Dr. Donohue, Presi- 
dent of the New York State Board of Health, read a paper on the "Exam- 
ination of the Milk Supply for Tuberculosis in the State of New York." 
It appears that a special Tuberculosis Commission was created in the 
State, May 1, 1894, the commission being clothed with authority to seize 
and destroy tuberculous animals, compensating the owners for damages. 

According to the author, the tuberculin test for tuberculosis in 
animals has not proved infallible, although a reliable aid in diagnosis. 



150 ANNUAL REPORT 

The subject of Hygiene in Schools was given considerable attention. 

Dr. Cameron of McGill University made a strong plea that greater 
attention 'should be paid in our schools to physical training. 

Dr. Monjaras, Inspector General of Public Health, of Mexico, presented 
a paper on "The Advisability of Teaching the Rules and Principles 
of Hygiene in the Primary Schools by Means of Object Lessons." The 
author advocated teaching young children hygiene by means of toys and 
magic lantern slides, using toy sanitary water closets, toy models of drains, 
toy disinfecting stoves, etc. "A doll house properly ventilated, provided 
with suitable sanitary appliances, in which the ground is shown drained 
with toy pipes, gives them a perfect idea of how a dwelling house should 
be built according to the best principles of hygiene, better than twenty 
pages of hygienic printed matter." 

Hygiene in Medical Education, by Dr. Desroches, of Montreal, Teach- 
ing the Principles of Hygiene to the Young, by Dr. Groff, of the Penn- 
sylvania State Board of Health, and Instruction in Hygiene in Schools 
and Colleges, by your Secretary, were read by title. 

A pleasant and instructive feature of the meeting was the trip by 
boat from Montreal to the quarantine station at Grosse Isle, thirty- one 
miles below Quebec. The disinfecting plant at this station is not excel- 
led, and possibly not equaled by any in the United States, It consists of 
three large square steel chambers, which are double jacketed with an air 
space between. There is also a double door at each end. In the bottom 
of the chambers tracks are laid connecting with outside tracks, so that 
cars loaded with articles for disinfection can be run into the chambers. 

Such articles are placed in open wire trunks or cages, provided with 
locks. The operation of a chamber is as follows : The air space between 
the two walls of the chamber is heated so as to prevent the condensation 
of steam when it is turned into the chamber, A vacuum pump connected 
with the chamber is then set in operation and about one-half of the 
atmospheric pressure is removed. This gives the steam greater penetra- 
ting power. Live steam is then turned into the chamber and the tempera- 
ture is maintained between 212° and 240° F., for about thirty minutes. 
Steam is allowed partially to escape from the chamber, the vacuum pump 
is again set in operation, and the disinfected articles are finally removed 
quite dry from the end of the chamber opposite to that at which they entered. 
A tight partition cuts off all outside connection between the ends of 
the chamber, so that disinfected clothing will not again become infected. 

By means of an electrical apparatus there is recorded the time during 
which each charge of articles for disinfection is maintained at a tem- 
perature between 212° and 240°. A thermometer with electrical connec- 
tions is placed in the center of a bale of goods as it goes into the chamber. 



OHIO STATE BOARD OF HEALTH. I5I 

When this registers 212° a bell is rung, and the time is counted from this 
moment. If the temperature rises above 240° or falls below 212° the bell 
again rings. An electric needle traversing a dial gives tracings on a card 
which show the exact time and temperature for each charge disinfected. 
The date of disinfection and the name of vessel from which the disinfected 
articles were taken are marked on each card, and these are preserved for 
future reference. Suit was recently brought against the Canadian au- 
thorities for the destruction of clothing. The proper card was produced in 
court and the suit was at once dismissed. 

Bath rooms are provided on the second floor of the building con- 
taining the disinfection plant. Healthy passengers removed from an 
infected ship are sent to the bath room where they undress, their clothes 
being removed for disinection. While waiting for clean clothing they 
are given a needle bath containing a disinfectant. 

The arrangements for the disinfection of vessels are less perfect. 
There is no deep water wharf and vessels must be treated and passengers 
landed in mid stream. In stormy weather this is practically impossible. 
Vessels are disinfected by means of sulphur fumigation, the mercuric 
drench, and by live steam where tight compartments can be secured. 
All vessels passing Grosse Isle are inspected. It found healthy and not 
coming from an in ected port, they pass on to Point Levis, near Quebec, 
where the immigrants — steerage passengers — are landed. There is a dis- 
infecting station at this point similar to the one at Grosse Isle, but with 
only one disinfecting chamber. The luggage of all immigrants allowed 
to pass Grosse Isle in disinfected at Point Levis, so that Canada is now 
disinfecting the baggage ot all immigrants. Why should the United 
States not do the same? 

A number of buildings on Grosse Isle provide ample quarters for 
different classes of cases and different classes of passengers. 

Dr. Wm. Bailey, of Louisville, was elected president. The next 
meeting will be hi:ld in Denver, Colorado. 

C. 0. Probst, Delegate. 



OPINIONS OF THE ATTORNEY GENERAL. 

POWER OF STATE BOARD OF HEALTH WITH REFERENCE TO PUBLIC WATER SUPPLIES. 

Columbus, June 25, 1894. 
Dr. C. O. Probst, Secretary Slate Board of HraHh : 

Dear Sir: In your favor of the 15th instant, you call my attention to Section 2 
of the act of March 14, 1893, which provides: 

"No city, village or private corporation or person shall introduce a public water 
supply or system of sewerage, or change or extend any public water supply or outlet of 



152 ANNUAL REPORT 

any system of sewerage now in use, unless the proposed source of such water supply or 
outlet of such sewerage system shall have been submitted to and received the approval 
of the State Board of Health," and submit the following questions : 

1. "If a city, village or private corporation or person introduces a public water 
supply or system of sewerage, and refuses or neglects to submit the same to the State 
Board of Health for approval, as required, how will the bonds issued to build a water 
works, or sewerage system, under such circumstances, be affected as to their legality? 

2, "If the Board examines a public water supply or system of sewerage introduced 
subsequent to March 14, 1893, without its approval, and finds good cause for not 
approving the source of the water supply or outlet of sewerage system, what action may 
be taken by the Board to prevent the use of such water supply or sewerage system?" 

In reply I beg to say : 

1. I do not think the bonds referred to will be invalidated for want of the approval 
of the State Board of Health of the proposed water supply or sewerage system. 

2. If a water supply is in use, introduced subsequent to March 14, 1893, which the 
State Board of Health has, for good grounds, refused to approve, the Board might call 
upon the city authorities to show cause why an order should not be made requiring the 
city to discontinue the use of the water supply until altered so as to comply with the 
reasonable views and requirements of the State Board. The local authorities should be 
afforded the opportunity of being heard. After they have been heard, or have refused 
to avail themselves of the opportunity of being heard, the State Board might make such 
order as the circumstances of the case require, and enforce the order by a prosecution 
under Section 2137 (as extended and made applicable to the orders of the State Board 
of Health, by Section 5 of the act of March 14, 1893), or by a suit in court enjoining the 
further use of the water supply until changed to conform with the order of the Board. 

Very respectfully, 
(Signed) J- K- Bichards, Attorney General. 



COUNCIL MAY BE COMPELLED TO PAY THE EXPENSES OF BOARDS OF 

HEALTH. 

Columbus, Ohio, June 25, 1894. 
Dr. C. O. Probst, Secretary State Board of Health : 

Dear Sir : In your favor of the 16th instant, you submit to me the following 
question : 

"Where a board of health had been properly and legally organized, and has 
appointed a health officer and fixed his salary ($80.00 per annum), and the council, upon 
application and certificate from the board of health, refuses to pay the salary of the 
health officer, what steps shall be taken by the board of health to compel the council to 
pay this expense of the said board ?" 

Section 2115, Revised Statutes, requires the board of health to appoint a health 
ofBcer, and empowers it to fix his salary. Section 2140 of the same chapter provides; 

" When expenses are incurred by the board of health, under the provisions of this 
chapter, it shall be the duty of the council, upon application and certificate from the 
board of health, to pass the necessary appropriation ordinances to pay the expenses so 
incurred and certified. " 

If the council or other city officers refuse without just cause to do the duty en- 
joined by this Feciion, a proceeding in mandamus might be instituted to compel the per- 
formance of such duty. 

Very respectfully, 

(Signed) J. K. Richards, Attorney General. 



OHIO STATE BOARD OF HEALTH. 1 53 



MUNICIPALITIES EESPONSIBLE FOR NUISANCES. 

Columbus, Ohio, October 3, 1894. 
Dr. C. O. Probst, Secretary Ohio State Board of Health : 

My Dear Sir: In reply to your inquiry of the 19th ult., I beg to say, that an 
examination of the law upon the subject leads me to believe that a municipal corpora- 
tion, which constructs a sewer with an outlet emptying into an open ditch within the 
corporation, thus creating a public nuisance, may be indicted for creating and main- 
taining a public nuisance. 

I refer you to : 

1. Wood in Nuisance, page 1,004 ; 

2. Dillon Municipal Corporations, Section 932, and the cases there cited ; also, more 
especially to case of State of Maine vs. The City of Portland, 74 Maine, 268, in which 
case an indictment against the city of Portland for constructing a public sewer in 
such a way that the outflow therefrom created a public nuisance, prejudicial to the 
public health, was sustained. In the report of this case the indictment is set out 
in full and reference given in the opinion to many cases bearing upon this subject. 

Very respectfully, 
(Signed) J. K. Richards, Attorney General. 



LIST OF 
M\jr\icipal Boards arxd JHealtK Officers. 

JANUAEY 1, 1895. 

CITIES. 

Akron L. S. Ebright, M. D. 

Alliance P. W. Welker. M. D. 

Bellaire D. W. Long, M. D. 

Bucyrus W. A. Daugherty, V. S. 

Canton J. F. March and, M. D. 

Chillicothe A. P. Cole, M. D. 

Cincinnati J. W. Prendergast, M. D, 

Circleville W. F. Tolbert. 

Cleveland Geo. F. Leick, M. D. 

Columbus D- N. Kinsman, M. D. 

Dayton A. H. Iddings, M. D. 

Defiance P- H. Aldrich, M. D. 

Delaware , W. B. Hedges, M. D. 

East Liverpool J. T. King. 

Fremont O. E. Phillips, M. D. 

Findlay Amos Beardsley. 

Fostoria J- O. Hess. 

Gallon A. Brokaw. 

Gallipolis E. Westlake, M. D. 

Greenville A. W. Rush, M. D. 

Hamilton P. E. Welsh. 

Ironton N K. Mrxl^y, Jr., M. D. 

Kenton... J. W. Binkley, M. D. 

Lancaster J- P- Hershberger, M. D. 

Lima L. J. 8teuber, M. D. 

Mansfield J. Harvev Craig, M. D. 

Marietta .' Conrad Ktrgbourn. 

Marion M. R. Swisher. 

Martin's Ferry R. A. Lindemnth. 

Massillon T.Clarke Miller, M. D. 

Middletown Geo. D. Luraiuis, M. D. 

Mt. Vernon Geo. B. Bunn, M, D. 

Newark W. C. Rank, M. D. 

Norwalk Edgar Martin, M. D. 

Piqua Will J. Prince, M. D. 

Pomeroy R. E. Stobart. 

Portsmouth C. C. Fulton, M. D. 

Salem F. T. Miles, M. D. 

Sandusky Elwood Stanley, M. D. 

Steubenville J. Buchanan, Clerk. 

Springfield H. H. Seys, M. D. 

Tiffin ... J. Bridinger, M. D. 

Toledo J. T. Woods, M. D. 



OHIO STATE BOARD OF HEALTH. 155 

Troy T. M. Wright, M. D. 

Urbana H.C.Houston, M. D. 

"Warren M. L. Williams, M. D. 

Washington C. H J. M. Edwards. 

Wellston R. A. Hutchinson. 

Wellsville Jos. T. Warren. 

Wooster J. W. Lehr, M. D. 

Xenia A. D. DeHaven, M. D. 

Youngstown H. E. Welch, M. D, 

Zanesville H. T. Sutton, M. D. 

VILLAGES. 

Aberdeen T. Heaton, M. D. 

^da W.H.Morrow. 

Adamsville S. J. Lane. 

Adelphi ^eo. B. Rose. 

Addystown J- M. Diller, M. D. 

Albany (Lee P. O.) A. F. Holmes, M. D. 

Alexandria D- H- Miller, M. D. 

i Allen town 

Alvordtown F. E. Schrider, M. D. 

Amanda (Clearport P. O.) J- D. Hufford, M. D. 

Amelia W. B. Doan, M. D. 

Andover T. R. Wood. 

j^nna ^- W. B. Harbour, M. D. 

Ansonia H. A. Snorf, M. D. 

Antwerp Chas. Roberts. 

iApple Creek 

Arcadia J- E. Bowman. 

Arcanum A. S. Ruby. 

Archbold August Ruihley. 

Arlington N. B.Anderson. 

Arlington Heights J- H. Franqis. 

Ashland.. R- Myers, M. D. 

Ashtabula A. W. Hopkins, M. D. 

Ashley •• H. N. Coomer, M. D. 

Ashville J. W. Johnson. 

jAthalia 

^t^igQg W.N. Alderman, M. D. 

Attica ZZZZZZZZZ A. W. Knight, M. D. 

tAuburndale (Part of Toledo) 

Avondale, Hamilton Co - Jos A. Brown. 

Bainbridge K- H. McKee, M. D. 

iBairdstown 

Baltimore B- K. Thomen, M. D. 

tBarryville : 

Barberton T. Eliott Tait, M. D. 

Barnhill ^- A. Douglas, M. D. 

Barnesville ^' ^' Laws, M. D. 

JBatavia 

Batesville F.M. Wardlow, M. D. 



t Not incorporated. 
t Not organized. 



156 ANNUAL REPORT 

Beach City E. W. Spidell, 

Bealsville Jno. W. Keed, M. D. 

Beaver Dam , C. H. Thomas, M. D. 

Bedford C. W. Kerslake. 

Bellbrook J. L.Sebring. 

Belle Center J. F. Dennis. 

Bellefontaine E. G. Reed, M. D. 

Belleville J. B. Lewis, M. D. 

JBelpre 

Bellevue John Earls. 

Belmore G. B. Adrain, M. D. 

Belmont W. C. Hedges. 

tBenton Ridge 

Berea T. G. Card. 

jBerne , 

iBerlin Heights 

Bethel W. W. Smith, M. D. 

iBettsville 

Beverly F. A. Pomeroy. 

Blake's Mills Chas. Shoop. 

Blanchester S. B. Judkins, M. D. 

Bloomingburg J. J. Pinkerton. 

Bloomdale E. Wineland. 

*Bloomfield (Bloomingdale P. O.) 

Bloomville F. S. Martin, M. D. 

Blufiton ... F. J. Baldwin, M. D. 

tBoliver , 

Bond Hill G. Perin. 

Botkins Allen Wical. 

JBoston , 

Bourneville D. S. Smith, M. D. 

Bowerston E. E. McPeck, M. D. 

Bowling Green A. Ordway. 

Bradford H. M. Forman, M. D. 

Bradner J. E. Furste, M. D. 

Bridgeport J.Andrew Heinlein,M. D. 

Brilliant McDougall, M. D. 

Brookfield W. E. Dunford. 

Brookville A. C. Berst. 

Broughton J. K. Sierer. 

Bryan Nicholas Vineyard. 

Buckeye City T. R. Neldon. 

Burbank M. H. Dodd, M. D. 

Butler J. M. McLaughlin, M. D. 

"^Butlerville D. A. Chapman. 

Burton B. A. Ray, M. D. 

Byesville Thos. Barnett. 

Cadiz M. J. Lyons, M. D. 

Caldwell O. O. McKee. 

Caledonia H. Ramer. 

*Calai8 



'•= Hamlet. 

t Not incorporated. 

t Not organized. 



OHIO STATE BOARD OF HEALTH. 1 57 

Cambridge G. D. Miller, V. S. 

Camden D. W. McQueen. 

Canal Dover E. Amick. 

Canal Fulton S. M. Buckmaster. 

Canal Winchester , L. W. Beery, M. D. 

Canfield A.D.Woods. 

tCannelville 

Cardinglon ..., S. C. Bennett. 

Carey J. D. Southward. 

Carroll H. A. Brown, M. D. 

Carrollton C. K. Ziegler, M. D. 

Carthage Harry Eoss. 

iCasstown 

Catawba T. D. Beach, M. D. 

Cecil H. L. Weaver. 

Cedarville T. V. Illifle. 

Celina L. P. Lisle, M. D. 

Centerburg W. B. Merriman, M. D. 

JCenterville 

Chagrin Falls J. H. Isaacs, Clerk. 

jChambersburg (Eureka P. O.) ,.... 

Chardon F. S. Pomeroy. 

Chester Hill J. A. Penrose, M. D. 

Chesterville Jno. Gleason. 

Chicago Junction D. H. Young, M. D. 

tChickasaw 

Clarington L. N. Timmons. 

Clarksville Z T. Garland, M. D. 

JClarksburg , 

Cleves W'. C. Hughes, M. D. 

Clifton, Hamilton county Wm. H. Bell, M. D. 

Clifton, Greene county D. E.Spahr, M. D. 

tClintOQ 

Coalton W. D. Hippell. 

Clyde Alex. Harnden. 

JColdwater 

College Hill E. F. Smith. 

Collinwood A. L. Waltz, M. D. 

Columbiana Geo. Roninger. 

Columbu- Grove Jno. K. Laflerty. 

♦Commercial Point W. A.Smith. 

jCongress , 

Conneaut E. D. Merriam, M. D. 

Continental (Marice City) S. H. Bretz. 

Convoy E. L. Crooks, M. D. 

Coolville A. M. Frame, M. D. 

*Copley O, E. Arnold. 

Corning G. W. DeLong, M. D. 

tCortland 

Coshocton H. Blackman. 

Covington S. C. Sisson. 

Crestline A. J. Cover. 



'■'- Hamlet. 

t Not incorporated. 

t Not organized. 



158 ANNUAL REPORT 

jUreston • - 

Cridersville Jas. P. Church. 

Croton Albert O'Harra. 

JCrown City 

Cumberland G- E. McEndree. 

Custar M. Worline, M. D. 

Cuvahcga Falls I. N. Reid. 

Cygnet S. A.Smith, M.'D. 

Dalton A. C. Stuck. 

Danville C. R. Bradfield, M. D. 

JDarbyville 

Deersville • Frank James, M. D. 

DeGraflf.....'." W. H. Hinkle, M. D. . 

Delta W. E. Ramsey. 

j)ellii M. L. Andrews. 

Dell Roy Isaac Yant, M. D. 

Delphos J- M. Marsh, M. D. 

Dennison S. L. McCurdy, M. D. 

Deshler J- 3- Lathrop, M. D. 

Dexter City E. B. Mosely. 

*Donnelsville Adam Cornwell. 

Doylestown A. E. Stepfield, M. D. 

Dresden Frank Comer. 

X)ublin ^- M. Merriman, M. D. 

Dunkirk 7 C. C. McLaughlin, M. D. 

Dupont Isaac Staley. 

East Fairfield G- H. Albright, M. D. 

East Palestine W. H. Olloman. 

East Springfield Geo. R. Wycoff, M. D. 

Eaton G. H. Jefierson. 

Edgerton C. Hathaway, M. D. 

Edison J. H. Jackson, M. D. 

j^don ^- H. Chisholm. 

Eldorado • J- A. Davison, M. D. 

j^lida Wm. Roush, M. D. 

Elmore S. T. Dromgold. 

Elyria W. F. McLean, M. D. 

Elmwood Place John Bart. 

jEmpire 

Enon Elwood Miller, M. D. 

tEuclid 

Fairfield Samuel Wilson. 

Fairport D- A.. Lewis. 

*Fairview John H.Hunt. 

Farmersville G. W. Neushawg. 

Fayette E. J. Emerick. 

JFayetteville 

Felicity G. E. Houghton. 

Fernbank John Ogden. 

• Fitchville E. L. Burton, M. D. 

Fletcher J. Funderburg, M. D. 

j; Florida 



- Hamlet. 

t Not incorporated. 

X Not organized. 



OHIO STATE BOARD OF HEALTH. 1 59 

Flushing J- V. Webster, M. D. 

Forest W. N. Mundy, M. D. 

Fort Jennings J- F. George, M. D. 

Fort Recovery John Watkins. 

Fowler C. D. Williamson, M. D. 

Frankfort J- O. Hoffhine, M. D. 

Franklin ..— N. A. Hamilton, M. D. 

Frazeysburg Joseph Martin. 

Fredericksburg L. C. Miller. 

Fredericktown. W. F. Gibson. 

Freeport W. A. Zellars, M. D. 

Fultonham A. R. Keyes. 

Gahanna J- Clinch, M. D. 

Gambier E. J. Hyatt, M. D. 

Garrettsville C. A. Snow, M. D. 

Geneva F. E. Tibbitts. 

Genoa J- L- Trutton, M. D. 

Georgetown R- B. Fee, M. D. 

Germantown , - G. W. Heisterman. 

JGettysburg 

Gibsonburg A. E. Ferguson. 

Gilboa M. A. Darbyshire, M. D. 

Girard A. J. Brooks, M. D. 

Glandorf.. Jacob Meyerhofer. 

Glendale E. A. Sayre. 

Glenville Chas. B.Cook, 

Glouster J- M. Rhodes, M. D. 

JGnadenhutten 

Good Hope D- C. Somers. 

Grafton John Isley. 

Grand Rapids William Mailey. 

Gratis P. O H. Bowman. 

Granville John Watkins, M. D. 

*Graysville C. H. Whittenrock, M. D. 

Green Camp F. W. Moses, M. D. 

Greenfield Scott Powell. 

Green Springs C. W. Skeggs, M. D. 

Greenwich , Robert Reynolds, M. D. 

*Grove City Chas. McGiven, M. D. 

GroverHill C. A. Bray, M. D.,8ec'y. 

Groveport C. R. Clement, M. D. 

Hamden J. T. Barrett. 

tHammondsville 

jHamersville 

Hamler L.J. Eger, M. D.; 

Hanging Rock Joseph Kinkaid. 

Hanoverton H- L- Milbourn. 

Harrison Thomas Bowles, Sec'y. 

Harmer John W. Knox. 

*Harrisburg C. H. Copeland, Clerk. 

Harrisville O. H. Colvill, M. D. 

Harrod D. P. Selleck. 

Hartford (Croton P. O.) 

Hartwell Lincoln Phillips, M. D. 

'■' Hamlet. 

\ Not organized. 



l60 ANNUAL REPORT 



jHaskins 

Harveysburg J. E. Witham, M. D. 

tHavensport 

Hayesville Dell Andress. 

Hebron E. M. Bonar, M. D. 

Herring J- B. McWilliams, M, D. 

Hicksville S. Blodget. 

Higginsport J. H. Williamson, M. D. 

Hilliards N. P.Davidson, M. D. 

Hillsborough H. M. Brown. 

Holgate J. G. Archer, M. D. 

Hollansburg A. W. Meek, M. D. 

Home City L. B.Terrill, M. D. 

Holmesville R. P. Loller, M. D. 

Hopedale , L. A, Crawford, M. D. 

HoytviUe E. F. Bell, M. D. 

Hubbard W. S. Bond, M. D. 

Hudson L. D. Osborne, M. D. 

Huntsville • J- S. Montgomery, M. D. 

Huron J- H.Calvin, M. D. 

Irondale Aaron Bullock. 

Independence Jas. C.Neville. 

Jackson W. H. Williams. 

*Jacksonboro 

Jacksonville W. W. Wolfe, M. D. 

Jamestown F. W. Ogan, M. D. 

Jefferson A. L. Arner, M. D. 

Jeffersonville D. H. Eowe, M. D. 

Jenera J. A. Hull. 

Jerusalem J- B. Shouse. 

Jerry City W. H. Frederick. 

j Jersey 

Jewett J- R Roberts. 

Johnstown J- D.Thompson, M. D. 

Johnsonville E. 0. Hitchcock. 

Junction City J. A. Moody, M. D. 

Kalida Jefferson Ladd. 

Kelley's Island Henry Eftlers. 

Kent L. G. Eeed. 

jKillbuck 

Kimbolton S. M. Mehaffey, M. D. 

Kingston C. B. James, M. D. 

Kirby E. E. Burns, M. D. 

jLafayette (Herring P. O.) 

LaGrange G. N. Snyder, M. D. 

Larue G. A. L. Markwith. 

Latty J- H. Horford, M. D. 

Laurelville Berman Friend. 

Laura 

Lebanon F. H. Frost, M. D. 

Leesburg H. A. Beeson, M. D. 

tLeesville ► 

Leetonia H. B. Kurtz. 



■■■■ Hamlet. 

I Not organized 



OHIO STATE BOARD OF HEALTH. l6l 

Leipsic John McClung, M. D. 

1:Lewisburg.... 

Lewisville M. Y. Thornberry. 

Lexington J. P. Stober, M. D. 

Liberty Center D. K. Bowker. 

^Limaville .. 

fLindsej 

Linwood , W. S. Reynolds. 

Lithopolis J.E.Holmes. 

*Little Sandusky , 

jLockington 

Lockland B. B. Latta. 

JLockville 

Lodi A. O. Mead. 

Logan L C. Wright, M. D. 

London ......... C. E. Gain, M. D. 

Lorain S. S. Cox, M. D. 

Loramies Thomas Walkup, M. D. 

tLoudonville .. 

Louisville J. H. Rodgers, M. D. 

Loveland William Scott, M. D. 

Lowell G. A. Phillips, M. D. 

Lowellville W. S. Baker. 

+Lucap 

Lynchburg Martin V. Nolder. 

Macksburg , R. C. Smithson. 

.Madison C. H. Quale, M. D. 

Madisonville E. A. Flinn, M, D. 

Magnetic Springs C. L. Swartz, M. D. 

Maineviile E. S. Garwood. 

Malta Z. Wiseman. 

Malvern E.C.Ross, M. D. 

Manchester R. A. Stephenson, M. D. 

t.Mapleton , 

Marblehead A. B. Jordan, M. D. 

+ Marl borough 

Marseilles C. H. Bower. 

Marshallville H. B. Wilford. 

*Martin8burg 

Martinsville W. K. Ruble, M, D. 

Marysvilie A. B. Swisher, M. D. 

Mason C. T. Hall, M. D. 

Maumee City , G. W. Rhonehouse, M. D. 

Marengo J. W. Pratt, M. D. 

McA.rthur , G. M. Swepston, M. D. 

McClure J. W. Sharp, M. D. 

McComb J. A. Thompson, M. D.. 

McConnelsville J. D. Maris. 

Meihanicsburg O. A. Nincehelser, M. Dl 

Mechanicstown J. M. Watt, M. D. 

Medina A. A. Foskett. 

Melrof^e R. E. Kingery. 

Mendon J, M. Miller, M. D. 

* Hamlet. 

X Not organized. 

11 ST. B. H. 



1 62 ANNUAL REPORT 

Mentor.. J. W. Lowe, M. D. 

Midland City E. C. Van Gundy, M. D. 

*Middle Creek 

Middleport A. Wilson, M. D. 

^Middle Branch 

tMiddle Point 

.Miamisburg W. S. Bookwalter, M. D. 

Milan. Richard Rawl. 

jVIilfofd F. C. Currv, M. D. 

Mil ford Center J. H. Welter, M. D. 

-Miltonsburg J. H. Pugh, M. D. 

*Milton 

*Milton Center J. F. Noble, M. D. 

JMillbury > 

tMilledgeville /. 

Millers M. McCowan. 

Millersburg J. E. Whitmar, M. D. 

tMillersport • -••• 

Mineral Point J. C. James. 

Mineral Kidge William Ohl. 

Minerva Thomas J. RoucK. 

tMinersville 

Mingo Junction.. . F. 8. Buchanan. 

Minster ._^. R- A. Rulman, M. D. 

jMohican 

Monroeville E. R. Kreider, M. D. 

Montpelier H. W. Weriz, M. D. 

Morristown R. S. Hazlett. 

Morrow B. F. Stiles, M. D. 

Moscow J- R- Wiley. 

iMt. Airy 

Mt. Blaochard J. Odenb^ugh, M. D. 

Mt. Cory W. E. Clymer. M. D. 

Mt. Healthy Frederick Walker. 

Mt. Gilead : M. G. Do'y. 

Mt. Pleasant J. A. McGlenn, M. D. 

*Mt. Grab J.A.Cumberland. 

Mt. Sterling C. T. Gallaghf-r. 

Mt. Washington J W. Dodds, M. D. 

Mt. Victory L. T Mahon, M. D. 

Murray City T. J. Diilenger, M. D. 

Mutual C. M Gonl. 

Napoleon L. V. Bf>i8on. 

Nashport H. L. Cunis. 

JNashville J. A. Underwood. 

.Navarre John Bailies. 

INelsonville Cha^. W. Cable. M. D. 

INevada G. F. Col«>, M. D. 

■Neville N. S. Hil', M. I'. 

Is^ew Albany C L. Holle, M. D. 

itNew Alexandria 

New Athens Albert Dickerson, M. D. 

tNew Baltimore 



'■- Hamlet. 

J Not organized. 



OHIO STATE BOARD OF HEALTH. 1 63 

iNe^ Bloomington (Agosta P. 0.) 

jNew Berlin , , 

New Bremen.. M. S Eckermeyer, M. D, 

New Carlisle Ben Davis, M. D. 

Newcomerstown „ J. R. McElroy, M. D. 

New Concord L. J. Graham, Secretary. 

tNew Franklin - , 

New Holland J. A. Dunlap. 

New Knoxville H.E.Fledderjoliana,M.D. 

New Lebanon Samael Bowman. 

New Lexington ; Jos B. Pdrter. 

New Lisbon E. G. Eells. 

New London W. B. Newk-irk. 

New Madison , J. S. F. Hageman. 

New Matamoras W. L. West, M. D. 

New Paris L S. Robinson, M. D. 

+New Petersburg 

New Philadelphia J. T. Maclean, M. D. 

New Richmond J. C. Evans, M. D. 

New Riegel John Moes, Jr. 

New Stark , J. F. Rudy, M. D. 

New Straitsville Marion Truex. 

*New Salem 

Newton Falls C. M. Rice, M. D. 

New Vienna R. T. Trimble, M. D. 

New Washington' J. F. Kimlerline. 

Ney P. M. Lehman, M. D. 

Niles.... F. Casper, M. D. 

North Amherst N. H. Cornwell, M. D. 

North Baltimore J. E. Somers, M. D. 

tNorth Bend 

North Lewisburg A. Spain. 

tNorth Lawrence 

North Robinson C. C. Mandeville, M. D. 

Norwich L. D. Wilson, Secretary. 

Norwood C. W. Tidball, M. D. 

Oak Harbor F. S. Heller, M. D. 

Oak Hill W. W. Morgan. 

Oakwood J. H. Stover. 

tOakland 

iOakley 

Oberlin E. L. Burge. 

Ohio City , E.E.Smith. 

Olmstead Falls C H. Barnum. 

JOrangeville 

Orrville H. Blankenhorn, M. D. 

■Osborne R. O. Hoover, M. D. 

Osgood J. W. Sprague. 

Osnaburg.. JoshuaWhiteleather, M.D. 

Ostrander G. E. Cowles, M. D. 

•Ottawa W. H. Wert. ' 



=■■ Hamlet. 

t Not incorporated. 

J Not organized. 



1 64 ANNUAL REPORT 

Ottoville A. Binder, M. D. 

Otway Alfred Jones. 

Oxford E. L. Hill, M. D. 

t Palestine 

* Patriot 

Patterson J. C. Gardner. 

Painesville D. J. Merriman, M. D. 

t Paris 

Pataskala Albert Stratton. 

Paulding P. A. Dix, M. D 

Payne J. D. McHenry, M. D. 

Peebles Jas. W. Yankie. 

Pemberville E. B. Morse. 

Peninsula W.N. Boerstler, M. D. 

Perrysburg - J. H. Rheinfrank, M. D. 

Perrysville v Geo. W. Shehan. 

+ Petersburg (Coal Grove P. O.) 

X Phillipsburg (Center P. O.).. 

t Pickerington 

X Pierce 

Piketon A. E. Bumgarner, M. D, 

Pioneer W. H. Durbin. 

Plain City M. J. Jenkins, M. D. 

Plainfield J.S.Jenkins. 

Pleasant Hill S. "W. Bausman, M. D. 

Pleasant Ridge F. D. Acomb. 

X Pleaeantville 

Plymouth M. Vance, M. D. 

Poland C. E. Justice, M. D. 

Polk W. H. Rhinehart, M. D. 

Portage W. C Philo, Sec'y. 

Port Clinton 

Port Jefferson S. S. Crumbaugh, M. D. 

Port Washington M. W. Nargney. 

X Port Union 

* Port Williams S. L. Thorpe. 

PowhattanPt J. 8. Boone, M. D. 

Proctorviile Amos Ripley. 

Prospect C. M. C. Thomas, M. D. 

Put-in-Bay F. W, Binggraf. 

Quaker City F. S. Miskimen, M. D. 

Quincy R. T. Cretcher. 

t Racine.. 

Earden R. A. Foster, M. D. 

Rawson Louis Henning. 

Ravenna.. Joseph Gledhill. 

Reading Henry Wachendorf. 

Eendville S. S. Jordan, M. D. 

X Republic .. 

Reynoldsburg F. G. Taylor, M. D. 

Richmond (Grand Eiver P.O.) James Averille. 

Richmond, Jeflerson county ,. Samuel Rothacker, M. D. 



* Hamlet. 
{Nat organized. 



OHIO STATE BOARD OF HEALTH. 1 65 



* Richville 

Eichwood W. M. Wood. 

Eidgeway E. B. Crow, M. D, 

Einggold James Davis, M. D. 

Eipley John P. Tyler, M. D. 

Eising Sun Martin Shively. 

Riverside,.. H. C. Eobinson. 

t Eobertsville 

Eockford T. G. McDonald. 

t Eochester„ 

Eock Creek W. S. Weiss, M. D. 

Eocky Ridge , Anson Green. 

Eoseville O. M. Norman, M. D. 

Eossville (Hagerman P. O.) E. H. Black, M. D. 

X Eoyalton 

Eushsylvania J. S. Mallory. 

Eushville W. G. Lewis, M. D. 

t Eusselville , 

Sabina J. L.Johnson. 

Salesville J. C Clark. 

Salineville Ealph Marsh. 

X Sarahsville 

Savannah L. S. Cowie. 

Scio M. L. McAdoo, Clerk. 

t Sciotoville 

Scott J. H. Eigor. 

Sedalia E. B. Mead, M. D. 

Senecaville W. Scott, M. D. 

Sekitan (Addyston.) 

Seville P. E. Beach, M. D. 

X Seven Mile 

Shawnee H. E. White, M. D. 

Shelby W. S. Anderson, M. D. 

X Sharon 

Sherrodsville W. H. Watkins. 

Sherwood E. J. Potter, M. D. 

Shiloh L. F. Henry, M. D. 

Shreve C. H. Lilley. 

Sidney Edwin LeFevre, M. D. 

Smithfield W. H. Wood, M. D. 

Smithville Simon Breneman. 

Somerset , W. W. Fulkerson. 

X Somerford 

Somerville E.H.Abbott. 

South Blocmfield E. E. Blacker, M. D. 

South Brooklyn E. E. Stickney. 

South Charleston T. G. Farr, M. D. 

South Point James Black, M. D. 

X South Salem 

South Solon W, F. McCormick, M. D. 

X South Webster 

Sparta S. G. Fowle. 



* Hamlet. 

t Not incorporated. 

% Not organized. 



1 66 ANNUAL REPORT 

Spencerville William Roush, M. D. 

Springborough. C. C. Langsden, M. D. 

'' Spring Hills - 

Spring Valley S. E. Dyke, M. D. 

St. Bernard S. B. Howard, M. D. 

St. Clairsville... D. L. Walker, M. D. 

St. Mary's W. B. Shoonover, M. D. 

St. Paris C. A. Oflfenbacher, M. D. 

t St. Louisville 

Stockport T, J. Lyne, M. D. 

Strasburg J. C. Schatzbach, M. D. 

Stouts P. O 8. B. Grimes, M. D. 

t Stoutsville 

Stryker George Snyder. 

Summerfield F. Rhodecker. 

t Summerford • 

Sugar Grove.. ,... T. K. Mason, M. D. 

Sunbury G. H. Gerhardt, M. D. 

Swanton - A. B. Lathrop, M. D. 

Sycamore R. S, Galleher, Esq. 

j: Syracuse , 

Sylvania Geo. A. Crandall. 

Tarlton J. B. Grove, Clerk. 

Taylorsville (PhiloP. O.) J. F. Addison, M. D. 

Tippecanoe City W. H. Strader. 

Tiro W. H. Guiss, M. D. 

Thornville Geo. H. Pugh, M. D. 

i Thurston - - 

Tontogany A. Eddmonn, M. D. 

Toronto B. F. Collins, M. D.,Sec'y. 

Trimble H. D. Danford. 

Tuscarawas.... C. D. Kurtz, M. D. 

Union City (P. O. Ind.) W. M. Grimes, M. D. 

i Unionville 

t Unionville Center , ^ 

Uhrichsville J. E. Groves, M. D. 

Utica M. F. Cole, M. D. 

Upper Sandusky O. C. Stutz, M. D. 

* Van Buren 

Vandalia W. H. Riley, M. D. 

Vanlue J. L. Schrotz, M. D. 

Van Wert E. W. Wilkinson, M. D. 

Vermillion Albert Matteson. 

Versailles W. H. Rike, M. D. 

Vinton Robert B. Carter. 

Wadsworth C. N. Lyman, M. D. 

Waldo J. R. Hippell, M. D. 

Wapakoneta J. R. Mouch, M. D. 

Warsaw S. W.Willis. 

Washington H. R. Ferrell, M. D. 

Washington ville J. C. Gorsuch. 

.t Waterloo <. 



* Hamlet. 

t Not organiaed. 



OHIO STATE BOARD OF HEALTH. lO 

Waterville Samuel^Down, M. D. 

Wauseon J. H. Waddell, M. D. 

Waverly Geo. D. Emmitt, M. D. 

Waynesburg E. G. McCormick, M. D. 

Waynesfield W. S. Turner, M. D. 

Waynesville W. E. Oglesbee, M. D. 

Webster J.IF. Byrd. 

Wellington M, W. Lang. 

West Alexandria L. J. Ashworth. 

West Cairo J. S. Clippinger, M. D. 

t West Carrollton - 

t West Chester 

West Cleveland G. A. Ehret, M. D. 

West Elkton Elwood Holaday, M. D. 

Westerville Jas. D. Budd. 

* Western Star 

West Jefferson , W. E. Postle, M. D. 

t West Leipsic 

West Liberty R. M. Fulwider, M. D. 

West Manchester David Allen. 

t West Mansfield 

t West Middleburg 

J West Mill Grove 

West Milton W. S.^Kessler, M. D. 

t West Norwood 

West Salem D. W. Carver, M. D. 

Weston 'Geo. B. Spencer, M. D. 

West Union W. R. Coleman, M. D. 

West Unity J. H. Tiddler. 

t West Wheeling 

Westwood Henry A. Faber. 

X Wheelersburg 

White House L. Bennett, M. D. 

Wilkesville J. A. Ewing, M. D. 

Williamsport G. O. Hayes, M. D. 

Windham H. J. Higby. 

Willoughby , E. G. Clark, M. D. 

Willshire J. K. Ross, M. D. 

Wilmington G. M. Austin, M. D. 

Winchester , C. W. Salisbury, M. D. 

Winton Place Jacob Vorhis. 

Woodsfield C. T. Huth, M. D. 

Woodstock D. P. Smith. 

WoodviUe Samuel Crawford. 

Worthington D. H. Welling. 

Wyoming A. M. Van Dyke. 

Yellow Springs W. M. Haffner, M. D. 

t York 

t Zanesfield 

Zileski F. M. Smallwood, M. D. 

Zoar Clement Breil, M. D. 



* Hamlet. 

X Not organized. 



Catalogue. 

LIBRARY OF THE 

Ohio State Board of Health, 

December 15, 1894. 



Book 



OORS. 



Abbott, A. C , M. D. Principles of Bacteriology, 1894. 

Accidents and Emergencies, 1888. Lawrence, James B., M. D. 

Accidents and Poisons, 1886. 

Althaus, Julius, M. D. Pathology and Prevention of Influenza, 1892. 

American Public Health Association. 

Public Health, Vols. XII, XIII, XIV, XV, XVI, XVII, XVIII, XIX, XX. 

Disinfection and Disinfectants, 1888. 

Lomb's Prize Essays. 1885. 
American Water Works, The Manual of, 1888, 1889-90, 1890-91. 
Animal Diseases, Relation of to Public Health, 1884. Billings, F. S., M. D. 

Bacteria, and the Germ Theory of Diseases, 1883. Gradle, H., M. D. 

Bacteria in Ice, 1887. Prudden, T. Mitchell, M. D. 

Bacteria, The Story of, 1891. Prudden, T. Mitchell, M. D. 

Bacteriological Diagnosis, 1892. Eisenberg, James, M. D. 

Bacteriology, 1893. Fraenkel Carl, M. D. 

Bacteriology, Maoual of, 1893. Sternberg, George M., M. D. 

Bacteriology, Practical, 1894. Migula. 

Bacteriology, Principles of, 1894. Abbott, A. C, M. D. 

Balch, Lewis, M. D. Manual for Boards of Health. 

Bartholow, Eobert, M. D. Cholera, 1893. 

Baumeister, E. The Cleaning and Sewerage of Cities, 1892. 

Benson, John A., M. D. Asiatic Cholera, 1893. 

Billings, F. S., D. V. S. Relation of Animal Diseases to Public Health, 1884. 

Billings, John S., M. D. Ventilation and Heating, 1890. 

Blyth, A. Wynter. Lectures on Sanitary Law, 1893. 

Bureau of Animal Industry. Reports, 1887-8, 1889-90, 1891-2. 

Special Report on Diseases of the Horse, 1890. 

Animal Parasites of Sheep, 1890. 

Swine Plague, 1891. 

Texas Fever, 1893. 

California, Register of Licensed Physicians and Surgeons, 1893. 

Census, Tenth United States. Vols. XI, XII, 1880. 

Cholera, 1893. Bartholow, Robert, M. D. 

Cholera, Asiatic, 1893. Benson, John A., M. D. 

Cholera and Yellow Fever in the Army of the United States, 1867. Woodward, J. 

J., M. D. 
Cholera Epidemic of 1873 in the United States. Woodworth, John M., M. D. 
Cholera Epidemic in East Africa, 1876. Christie, James, M. D. 
Cholera in Europe and India, 1890. Shakespeare, E. O , M. D. 
Christie, James, M. D. Cholera Epidemic of 1873 in the United States, 1876. 
Columbus Directory, 1894. 
Commissioner of Education, Report of. 1884-5. 
Connecticut Medical Society. Transactions, 1891. 
Corfield, W. H. Treatment and Utilization of Sewage, 1887. 
Cushing's Manual. 



172 ANNUAL REPORT 

Department of Agriculture. Third Keport of the United States Entomological Com- 
mission, 1880-2. 
Dibble, F. L., M. D. Vagaries of Sanitary Sciences, 1893. 
Disinfection and Disinfectants, 1888. American Public Health Association. 
Doty, Alvah H , M. D. Prompt Aid to the Ini'ured, 1889. 

Drainage of Houses and Towns, The Sanitary, 1886. Waring, Geo. E., Jr., C. E. 
Drysdale, J., M. D. Health and Comfort in House Building, 1886. 
Dust and its Dangers, 1891. Prudden, T. Mitchell, M. D. 

Eisenberg, James, M. D. Bacteriological Diagnosis, 1892. 

Emergencies, 1890. Howe, J. W., M. D. 

Engineering News. The Manual of American Water Works, 1888, 1889-90, 1890-91. 

Executive Documents. 2 vols., 1886. 2 vols., 1890. 

Fevers, Eruptive and Continued, 1893. Moore, John W., M. D. 

Florida, Register of Licensed Physicians in, 1893. 

Fraenkel Carl, M D. Bacteriology, 1894. 

Frankland, Percy M., M. D. Micro-Organisms in Water, 1894. 

Geological Survey of Ohio. 

Paleontology. Vols. I, II, 1873-75. 

Geology. Vols. I, II, 1873. 

Economic Geology. Vol. VI, 1888. 

Annual Eeport, 1890. 
Gerhard, William Paul, C. E. Sanitary House Inspection, 1889. 
Glazier, W. C, M. D. Trichina and Trichinosis, 1881. 
Germ Plasm, The, 1893. Weisman, August, M. D. 
Gradle, H., M. D. Bacteria and the Germ Theory of Disease. 

Health and Comfort in House Building, 1886. Drysdale, J., M. D. 

Health, A Primer of, 1892. Stowell, Chas. H., M. D. 

Health, The Essentials of, 1892. Stowell, Chas. H., M. D. 

Healthy Body (A) 1892. Stowell, Chas. H., M. D. 

Homan, George, M. D. A Sanitary Survey of St. Louis, 1884. 

Homeopathic Medical Society (Ohio) Proceedings, 1889. 

Hope, George H , M. D. Till the Doctor Comes, 1871. 

Howe, J. W., M. D. Emergencies, 1890. 

Horse, Special Report on Diseases of. Bureau of Animal Industry, 1890. 

Hunt, Ezra M., M. D. Principles and Practice of Hygiene, 1886. 

Hygiene and Public Health, 1890. Parkes, Louis. 

Hygiene and Sanitary Science, A Handbook of, 1880. Wilson, George H., M. D. 

Hygiene, Methods of Practical. 2 vols., 1893. Lehman, K. B. 

Hygiene, Practical, 1893. Parkes, Louis. 

Hygiene, Principles and Practice of, 1886. Hunt, Ezra M., M. D. 

Hygiene, Text Book of, 1890. Rohe, George H., M. D. 

Hygiene, Treatise on, 1893. 3 vols. Stevenson & Murphy. 

Illinois Report of Medical Colleges, 1865-91, 1892. 

Illinois Water Supply, 1893. 

In Case of Accident, 1884. Sargent, D. A., M. D. 

Index Catalogue, Library Surgeon General's Office, United States Army. 15 vols. 

Infectious Diseases, Hygienic Measures in Relation to, 1893. Nutthall, George, M. D. 

Influenza, Pathology and Prevention of, 1892. Althaus, Julius, M. D. 



OHIO STATE BOARD OF HEALTH. 1 73 

Laws, Lectures on Sanitary, 1893. Blyth, A. Wynter. 
Laws of Ohio. Vols. 87, 88, 89, 90, 91. 
Laws Regarding Public Health (Kentucky), 1886-7. 
Lawrence, James B., M. D. Accidents and Emergencies, 1888. 
Leffman & Beam. Examination of Water, 1891. 

Analysis of Milk and Milk Products, 1893. 
Lomb's Prize Essays, 1885. American Public Health A.ssociation. 

Manual for Boards of Health. Balch, Lewis, M. D, 

Manual of the Health Department of Boston, Mass., 1890. 

Marine Hospital Service, Report of the Operation of, 1884. 

Weekly Abstracts of Sanitary Reports, 1890, 1891, 1892, 1893. 

Massachusetts State Board of Health. Examination of Water Supp'ies, 1890. Purifi- 
cation of Sewage and Water, 1890. Sewage of the Mystic and Charles River 
Valleys, 1889. 

Medical and Chirurgical Faculty of the State of Maryland. Transactions, 1886, 1888, 
1889, 1890, 1892, 1893. 

Medical Association of the State of Alabama. Transactions, 1886, 1887, 1888, 1892, 1893. 
Rules of. 

Medical and Surgical Register of the United States, 1893. 

Medical Colleges, Illinois Report on, 1765-1891, 1892. 

Medical Dictionary, 1886. Thomas, Joseph, M. D. 

Memoirs of the National Academy of Sciences. Vol. Ill, Part I, 1884. 

Messages and Documents of the War Department. Vols. I, II, III, 1885-6. 

Micro-Organ isms in Water, 1894. Frankland, Percy M., M. D. 

Microscope, Use of the. Rafter, Geo. W , C. E. 

Miasmatic Fever in Maryland, Special Report on. 

Miers and Crosskey. The Soil in Relation to Health, 1893. 

Migula , Practical Bacteriology, 1894. 

Milk and Milk Products, Analysis of, 1893. Leffman and Beam. 

Missouri State Medical Society. Transactions, 1888. 

Moore, John W., M. D. Eruptive and Continued Feve's, 1893. 

Mortality (Comparative) in Massachusetts, 1871-1878. 

National Board of Health, 1879, 1880, 1881, 1882, 1883. 

National Funeral Directors' Association. Official Text Book and Lexicon, 1887. 
Nebraska, Register of Licensed Physicians, 1892. 

New Hampshire Medical Society. Transactions, 1886, 1887, 1888, 1890. 
New Hampshire, Report Commissioner of Lunacy, 1890, 1891. 
New Hampshire School Report, 1890. 
New Jersey School Report, 1890. 

New York State Dairy Commissioner. Fifth Annual Report. 

New York Academy of Medicine. Transactions. Vols. I, II, III, IV. V VI VII 
VIII, IX. - . > » 

North Carolina Sanitary Association, 1889. 
Nuithall, George, M. D. Hygienic Measure, in Relation to Infectious Diseases, 1893. 

Official Text Book and Lexicon, 1887. National Funeral Directors' Association. 

Ohio Directory, 1894. 

Ohio State Medical Society. Transactions, 1889, 1893, 1894. 

Palmberg, Albert, M. D. Public Health and its Applications, 1893. 
Parker and Worthington. Public Health and Safety, 1893. 
Parkes, Louis. Hygiene and Public Health, 1890, Practical Hygiene, 1893. 
Pennsylvania Regi^ter of Physicians, 1888. 



174 ANNUAL REPORT 

Pennsylvania Pharmaceutical Association. Proceedings, 1886. 

Pennsylvania State Medical Society. Transactions, 1887, 1888, 1889, 1890. 

Pierson, George S., C. E. The Separate System of Sewerage, 1894. 

Postal Guide, United States, 1893. 

Preventive Medicine, 1884. Richardson, B. F., M. D. 

Proceedings Homeopathic Medical Society. Ohio, 1889. 

Proceedings of Pennsylvania Pharmaceutical Association, 1886. 

Proceedings of Pennsylvania State Sanitary Association, 1886, 1888. 

Prompt Aid to the Injured. Doty, Alvah H., M. D. 

Prudden, T. Mitchell., M. D. Bacteria in Ice, 1887. Dust and its Dangers, 1891.|Drink- 

ing Water and Ice Supplies, 1890. The Story of the Bacteria, 1891. 
Ptomaines and Leucomaines, 1891. Vaughan and Novy. 
Public Health and Safety, 1893. Sykes, John J. F. 
Public Health. Vols. XII, XEII, XIV, XV, XVI, XVII, XVIII, XIX, XX. American 

Public Health Association. 
Public Health Problems, 1893. Sykes, John J. F. 
Public Health and its Application, 1892. Palmberg, Albert, M. D. 

Rafter, George W., C. E. Use of the Microscope. 

Rafter and Baker, 1893. Sewage Disposal in the United States. 

Register of Licensed Physicians and Surgeons, California,. 1893. 

Register of Licensed Physicians in Florida, 1893. 

Register of Physicians in Pennsylvania, 1888. 

Register of Licensed Physicians, Nebraska, 1893. 

Revised Ordinances, Mansfield, Ohio, 1893. 

Revised Statutes, State ol Ohio. 2 vols., 1888. Smith and Benedict. 

Richardson, B. F., M. D. Preventive Medicine, 1884. 

Rohe, George H , M. D. Text Book of Hygiene, 1890. 

Roster of the Ohio Soldiers in the War, 1892. Vols. I, XT. 

Sanitary Engineer. Steam Heating Problems, 1886. 

Sanitary House Inspection, 1889. Gerhard, William Paul, C. E. 

Sargent, D. A., M. D. In Case of Accident, 1884. 

Sewage Disposal in the United States, 1894. Rafter and Baker. 

Sewage and Water, Purification of, 1890. Mass. State Board of Health. 

Sewage, Treatment and Utilization of, 1887. Corfield, W. H. 

Sewage of the Mystic and Charles River Valleys, 1889. Mass. State Board of Health. 

Sewerage and Cleaning of Cities, 1892. Baumeister, E. 

Sewerage, The Separate System of, 1894. Pierson, George S , C. E. 

Shakespeare, E. O., M. D. Cholera in Europe and India, 1890. 

Sheep, Animal Parasites of, 1884. Bureau of Animal Industry. 

Smead, Isaac D. Warming and Ventilation, 1890. 

Smithsonian Institute Reports, 1880. Part< I, II. 

Soil in Relation to Health, The, 1893. Miers and Crosskey. 

St. Louis. A Sanitary Survey of, 1884. Homan, George, M. D. 

Steam Heating Problems, 1886. Sanitary Engineer. 

Sternberg, George M., M. D. Manual of Bacteriology, 1893. The Etiology and Preven- 
tion of Yellow Fever, 1891. 

Stewart, James A., M. D. Report of Health Department of Baltimore, Maryland, 1888. 

Stevenson and Murphy. Treatise on Hygiene. 3 vols., 1893. 

Stowell, Charles H., M. D. A Healthy Body, 1892. A Primer of Health, 1892. The 
Essentials of Health, 1892. 

Swine Plague. Bureau of Animal Industry. i 

Sykes, John J. F. Public Health Problems, 1892. 



OHIO STATE BOARD OF HEALTH. 1 75 

Tennessee State Medical Society. Transactions, 1889, 1891. 

Texas Fever, 1893. Bureau of Animal Industry. 

Thomas, Joseph, M. D. Medical Dictionary, 1886. 

Till the Doctor Ck)mes, 1871. Hope, George H., M. D. 

Transactions, Medical Association of the State of Alabama, 1886, 1887, 1888, 1892, 1893' 

Transactions, Connecticut Medical Society, 1891. 

Transactions, Medical and Chirurgical. Faculty of the State^ofi^Maryland, 1^86, 1887, 

1889, 1890, 1894. 
Transactions, Missouri State Medical Society, 1888. 

Transactions, International Medical Gongrei^. 9th Session.! Vols. Ill, IV, V. 
Txanisactions, New Hampshire Medical Society, 1887, 1888. 
Transactions, New York Academy of Medicine. Vols. I, II, III, IV, V, VI, VII, VIII, 

IX. 
Transactions, Ohio State -Medical Society, 1889, 189*, 1894. 
Transactions, Pennsylvania State Medical Society, 18S7, 1888, 1889, 1890. 
Transactions, Tennessee State Medical Society, 1889, 1891. 
Transactions, Vermont State Medical Society, 18&7. 
Tsichina and Trichinosis, 1881. Glazier, W. C, M. D. 

University of Nebraska. Experiment Station, 1889, 1890, 1891, 1892, 1893. 

Vaccination, Report of the Royal (Commission on. 5 vols., 1893. 
Vagaries of Sanitary Science, 1893. Dibble, F. L., M. D. 
Vaughan and Novy. Ptomaines and Leucomaines, 1891. 
Ventilation and Heading, 1890. Billings, John S., M. D. 

Vital Statistics. District of Columbia and Baltimore, 1860. New York-City and Brook- 
lyn, 1890, 

Waring, Geo. E., Jr., C. E. The Sanitary Drainage of Houses and Towns, 1866. 

Warming and Ventilation, 1890. Smead, Isaac D. 

Water Supply and Sewerage, 1890. Massachusetts State Board of Health. 

Water Supply of Illinois, 1893. Illinois State Board of Health. 

Water (drinking) and Ice Sjiipplies, 1891. Prudden, T. Mitchell, M. D. 

Water, Examination of, 1891. Leffman and Beam. 

Water, Purification of, 1890. Massachusetts State Board of Health. 

Water Supplies, Examination of, 1889. Massachusetts State Board of Health. 

Weekly Abstracts of Sanitary Reports. Vols. V, VI, VII, VIII, Marine Hospital 

Service. 
"Weisman, August, M. D. The Germ Plasm, 1893. 
"Wilson, George. Handbook of Hygiene and Sanitary Science, 1880. 
Woodward, J. J., M. D., Report on Epidemic Cholera and Yellow Fever in the United 

States Army in 1867. 
Woodworth, John M., M. D. Cholera Epidemic of 1873 in the United States, 1876. 

Yellow Fever, The Etiology and Prevention of, 1891. Sternberg, Geo. M., M. D. 
Yellow Fever and Epidemic Cholera in the United States Army in 1867. W^oodward, 
J. J., M. D. 

REPORTS OF STATE BOARDS OF HEALTH. 

Alabama, 1887, 1888, 1889, 1890, 1891. 

California, 1880, 1881, 18S6, 188S, 1890, 1892, 1893. 

■Connecticut, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893. 



176 ANNUAL REPORT 

Delaware, 1888-90, 1890-92. 

District of Columbia, 1887, 1888, 1889, 1890, 1891. 

Florida, 1890, 1891, 1892, 1893. 

Illinois, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892. 

Eegistration, 1884, 1887. 

Medical Education, 1765-1890, 1765-1891. 
Indiana, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1892, 1893. 
Iowa, 1881, 1883, 1885, 1887, 1891. 

Registration, 1893. 

Kansas, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893. 

Maine, 1885, 1886, 1887, 1888, 1889, 1891. 

Maryland, 1888, 1889, 1892, 1894. 

Massachusetts, 1885, 1886, 1887, 1888, 1889, 1890, 1892, 1893. 

Registration, 1885, 1888, 1889, 1890. 
Michigan, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880,1881, 1882, 1883, 1884, 1885, 1886, 
1887, 1888, 1889, 1890, 1891. 

Registration, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1878, 1879, 1880, 1881, 1882, 
1883, 1889, 1891, 1892. 
Mississippi, 1880, 1881, 1886, 1887, 1889, 1891. 
Missouri, 1886, 1887, 1889, 1890, 1891. 

New Hampshire, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893. 

Registration, 1884, 1885, 1886, 1887, 1888, 1889, 1890. 
New Jersey, 1879, 1880, 1884, 1885, 1886, 1887, 18S8, 1889, 1890, 1892, 1893. 
New York, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893. 
North Carolina, 1887, 1892. 

Oklahoma Territory, 1892. 

Ontario, 1883, 1884, 1886, 1887, 1888, 1889, 1890, 1891, 1892. 

Pennsylvania, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892. 

Rhode Island, 1878, 1879, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891. 
Regis. ration, 1880, 1882, 1883, 1884, 1886. 

South Carolina, 1881, 1882, 1883, 1884, 1886, 1887, 1888, 1889. 
South Dakota, 1892. 

Tennessee, 1877- 80, 1880-84. 

Vermont Registration, 1886, 1887, 1888. 

Washington, 1892, 1893. 

West Virginia, 1884, 1888, 1889, 1890, 1891, 1892. 

Wisconsin, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1885, 1886, 1887, 1888, 1889, 1890, 
1891, 1892. 



OHIO STATE BOARD OF HEALTH. 1 77 

EEPOKTS OF CITY BOARDS OF HEALTH. 
Atlanta, Ga., 1889. 

Baltimore, Md., 1888. 

Boston, Mass., 1890. 

Brooklyn, N. Y., 1877, 1878, 1879, 1880, 1881, 1885, 1886. 

Buffalo, N. Y., 1886. 

Charlestown, S. C., 1889. 

Chicago, II]., 1886, 1887, 1888, 1889. 

Concord, N. H., 1886. 

Davenport, Iowa, 1892, 1893. 
Dublin, Ireland, 1893. 
Dubuque, Iowa, 1894. 

Erie City, Pa., 1888. 

Fall River, Mass., 1889. 

Hartford, Conn., 1887, 1889, 1890, 1891. 
Haverhill, Mass., 1889. 

Indianapolis, Ind., 1891. 

Kansas City, Mo., 1886. 

Keokuk, Iowa, 1888, 1889, 1890, 1892. 

Liverpool, England, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890 1891 
1892, 1893. ' 

Louisville, Ky., 1893. 
Lowell, Mass., 1886. 
Lynn, Mass., 1886, 1888, 1889, 1890, 1892. 

Memphis, Tenn., 1889, 1890, 1891, 1892. 
Milwaukee, Wis., 1892, 1893. 
Minneapolis, Minn., 1887, 1888, 1891. 
Montreal, Canada, 1885, 1886, 1887, 1888, 1889. 

Newark, N. J., 1885, 1886, 1887, 1888, 1889. 

Newburgh, N. J., 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890. 

Pittsburgh, Pa., 1880, 1881, 1882, 1883, 1884, 1886, 1886, 1887, 1888, 1889, 1880. 
Portland, Me., 1889, 1893. 

Reading, Pa., 1886, 1893. 

San Antonio, Texas, 1886, 1889, 1892. 

San Francisco, Cal., 1891. 

St. Louis, Mo., 1893. 

St. Paul, Minn., 1890, 1893. 

12 ST. B. H. 



lyS ANNUAL REPORT 

Toronto, Canada, 1886, 1888, 1890. 

Wilmington, Del., 1885. 
Winona, Minn., 1898. 



REPORTS OF OHIO CITIlCfK 



Akron, 1892, 1893. 
Avondale, 1894. 

Cincinnati, 1879, 1880, 1881, 1882, 1883, 1885, 1886, 1887, 1888, 1889, 1880, 1891, 1W2, 

1893. 
Cleveland, 1885, 1886, 1887, 1888, 1889, 1890, 1892. 
Columbus, 1888, 1889. 

Dayton, 1885, 1886, 1887, 1888, 1889, 1890, 1898. 

Fremont, 1891. 

Glendale, 1890. 

Mansfield, 1888, 1889, 1890, 1891, 1892. 
Masfiillon, 1892, 1893, 1894. 
Middletown, 1886, 1887, 1888, 1890. 

Piqua, 1889, 1890. 

Sandusky, 1887. 
Sidney, 1890, 1891, 1892. 

Toledo, 1886, 1887, 1889, 1890, 1892. 

Urbana, 1891. 

Wapakoneta, 1889. 

Younsstown, 1889, 1890. 

LAWS, RULES AND REGULATIONS OF STATE BOARDS OF HEALTtt 

Alabama, Maine, Ontario, 

Canada, Manitoba, Pennsylvania, 

Connect! Maryland, Quebec, 

Delaware, Massachusett*, Rhode Island, 

Florida, Michigan, Tennessee, 

Indiana, New HampsMre, United States, 

Iowa, New Jersey, Vermont, 

Kansas, New York, Washington, 

Kentucky, Ohio, 



OHIO STATE BOARD OF HEALTH. 



179' 



RULES AND REGULATIONS OF OHIO BOARDS OF HEALTH. 



Ansoaia, 

Ashland, 

Ashley, 

Archbold, 

Bainbridge, 

Bedford, 

Bellaire, 

Beverly, 

Bloomingburg, 

Bloomville, 

Brookville, 

Bucyrus, 

Cambridge, 

Carey, 

Cedarville, 

Celina, 

Circleville, 

Cleveland, 

Clifton, 

CoUinwood 

Columbus, 

Conneaut, 

Cuyahoga Falls, 



Delphoe, 

Deshler, 

East Liverpool, 

Fayette, 

Franklin, 

Garrettsvillt, 

Geneva, 

Gil boa, 

Glendale, 

Glenville, 

Groveport, 

Hamilton, 

Hartwell, 

Ironton, 

Logan, 

Lowell, 

Madisonville, 

Mansfield, 

Marysville, 

McComb, 

MiddletowD, 

Millersburg, 

Minster, 



Murray City, 

New Paris, 

New Philadelphia, 

New Straitsville, 

New Vienna, 

North Baltimore, 

Ottawa, 

Oxford, 

PainesviUe, 

Perrysburg, 

Piqua, 

Salesville, 

South Brooklyn, 

Troy, 

Versailles, 

Warren, 

Washington, 

Wellsville, 

West Cleveland, 

West Liberty, 

Woodsfield, 

Youngs town, 

Zanesville. 



PAMPHLETS. 

Abbott, S. W., M. D. The Story of the New England Kitchen. 

Air (Impure) and the Ventilation of Private Dwellings. Van Rensselaer, Howard, M. D. 

Allen, Dudley P., M. D. A Resume of Surgical Operations. 

American Medical Association, Proceedings. Forty-Second Annual Meeting. 

American Public Health Association. 

The Cause and Prevention of Diphtheria. 

Disinfectants. 

Disinfection of Rags. 

Disinfection and Disinfectants. 

Pollution of Water Supplies. 
Amplifier, On the Use of. Rafter, George W., 0. E. 
Animal Vaccine. The Inoculation of the Virus of. Martin, S. C, M. D. 
Annual Address Ohio State Board of Health. Cretcher, W. H., M. D. 
Annual Address Pennsylvania State Board of Health. Evans, S. F., M. D. 
Annual Address Pennsylvania State Board of Health. Dixon, Samuel G., M. 9. 
Annual Appropriations for State Boards of Health, 1892. 
Antiseptic Wound Treatment, Modern Method of. Johnson & Johnaon. 
Apex Catarrh. Straight, Howard S., M. D. 
Architecture and Sanitation. Gerhard, William Paul, C. E. 
Arsenic, The Use of in Dermatology. Ricketts, B. Merrill, M. D. 
Asceptic Celiotomy, Results of. Wathien, W. H., M. D. 
Asexualization as a Penalty for Crime and the Reformation of Criminals. Brerti, 

Orpheus, M. D. 
Atkinson, Edward, L. L. D, The Art of Cooking. The Right Application of Heat for 
the Conversion of Food Material. 



l8o ANNUAL REPORT 

Bacteriology in Medicine. Bailey, Wm. C, M. D. 

Bailey, William C, M. D. Bacteriology in Medicine. 

Baker, Albert K, M. D. Address at the opening of the Medical Department of the 
Wooster University. Consequences of Acute Suppuration of the Middle Ear with 
Special Reference to Opening the Mastoid. 

Baker, H. B., M. D. A Plea for Public Health Work in Villages. Recent Advances in 
State Medicine. The Causation of Cold Weather Diseases. Malaria and the Causa- 
tion of Intermittent Fever. National Conference of State Boards of Health, 1886. 
The Relation of Rainfall and Water Supply to Cholera. Consumption, Causation of.. 

Baldwin, J. F., M. D. The Relation of Ozone to Disease. 

Bancroft, George. Abraham Lincoln. Memorial Address. 

Bange, Theodore, M. D. Milk Inspection in Cincinnati, O. 

Beckwith, D. H., M. D. Sanitary Disposal of the Dead. Sewers and Sewer Gases. The 
Hot Springs as a Summer Resort. Construction of Hospitals. Vaccination. 

Beebe, H. E., M. D. Influence of Ice and Its Impurities in Disease. 

Beef Inspection as a Part of Public Hygiene. Yonkerman, D. P., V. S. 

Beri-beri, Eight Cases of, in Philadelphia. Boerning, C. H., M. D. 

Billings, John S., M. D. Swine Plague. Southern Cattle Plague and Yellow Fever. 

Biological Examination of Mohawk River Water. Brown, Charles E., C. E. 

Biological Examination of Potable Water. Rafter, George W., C. E. 

Blanc, Henry W., M. D. Leprosy in New Orleans. 

Blood Corpuscles, The Comparative Size of in Man and Domestic Animals. Detmerg, 
Freda, B. Sc. 

Board of Live Stock Commissioners. Bulletin 1. 

Boerning, H. C, M. D. Eight Cases of Beri-beri in Philadelphia. 

Bouecaren, G. Final Report of the Trustees of the Covington Reservoir. 

Bradley, G. B., M. D. LaGrippe Epidemic with Treatment. 

Brooklyn Health Exposition, The. 

Brown Charles E., C. E. Biological Examination of Mohawk River Water. 

Brush, Edmund C, M. D. Shock. 

Bryce Peter H., M. D. Report on the Quarantine System of the St. Lawrence, 1886. 

Report on an Outbreak of Venereal Diseases Amongst Horses in 
the County of Kent, Ontario. Rules for Checking Infectious and Contagious diseases. 

Bureau of Hygiene and Sanitation. The World's Columbian Exposition. 

Bureau of Medicine and Surgery. Report of the Chief to Secretary of Navy, 1885. 

Bureau of Public Health. Address in re a proposed bill to establish. Walter Wyman, 
M. D. 

Bush, L. P., M. D. Resuscitation of the Drowned. 

Burghardt, Joseph, M. D. Therapeutics of Diphtheria. 

California, Proceedings of Sanitary Convention, San Francisco, 1893. 

Calkins, G. N. Massachusetts Registration Report. 

Carrouthers, M. M , M. D. The Cremation of Waste and Garbage. 

Catlin A. M., M. D. Oxygen as a Distinct Remedy for Disease. 

Cattle Transportation, Regulation Concerning. 

Causes of Death, Nomenclature. Rhode Island State Board of Health. 

Central Indiana Hospital for Insane. Annual Report of, 1893. 

Chaille Stanford E., M. D. Life and Death Rates ; New Orleans and other cities com- 

pared. 
Chancellor, C. W.,„M. D. Improved Methods for Sewage Disposal. Observations on. 

Cholera and Quarantine. 
Ohapin, L. E., C. E. Sewage Disposal at Canton, Ohio. 
Cheesman, T. M., M. D. Sanitary Inspection of the Croton Water Supply. 
Children, The Growth of. Peckham, George W., M. D. 
Children's Home, Clinton county, Ohio. Report of, 1890. 



OHIO STATE BOARD OF HEALTH. lb I 

Children's Home, Fairmount, Ohio. Annual Report of, 1892. 

Chittenden, T. W. School Hygiene, and what the Teacher can do to Promote it. Our 

School Houses. 
Cholera and Quarantine, Observations on. Chancellor, C. W., M. D. 
Cholera Infantum. Miller, T. Clarke, M. D. 
Cholera, Preparation of the City of Brooklyn for the Anticipated Epidemic in 1884-5. 

Raymond, Joseph H., M. D. 
Cholera, Sulphur Fumigation in. Raymond, Joseph H., M. D. 
Cholera, The Relation of Rainfall and Water Supply to. Baker, H. B., M. D. 
Cincinnati Hospital, Annual Report, 1888, 1889, 1890, 1891, 1893. 
Cincinnati Sanitarium, Annual Report of Superintendent, 1887, 1888. 
Circumcisions (150) and what they Teach. Ricketts, B. Merrill, M. D. 
City Progress and Public Health. Plunkett, J. D., M. D. 
Clark, A. Arnold, M. D. The Prevention of Consumption. 

Clark, C. F., M. D. Small-pox Cases and their Management During the Recent Out- 
break in Bufialo, N. Y., 1890. 
Clendennin, William, M. D. In Memoriam. Falls, William Henry, M. D. 
Cold Weather Diseases, The Causation of. Baker, H. B., M. D. 
Coley, William B., M. D. A Clinical Report of Operative Surgery in the Service of Dr. 

William Bull. 
Colorado Springs, Medical Facts Concerning. Knight, Frederick I., M. D. 
Commissioner of Pensions. Annual Report, 1887. 
Communication of Disease, Notes on. Corlett, William Thomas, M. D. 
Compulsory Education in Ohio. Brief for Defendant in Error. Richards, J. K. 
Conn, G. P., M. D. Hygienic Condition of ^ssenger Coaches. 
Conklin, W. J., M. D. Some Neuroses of the Menoplasm. The Influence of School 

Life on the Eyesight. 
Consequences of Acute Suppuration of the Middle Ear. Baker, A. R., M. D. 
Consular Reports, 1894. 

Consumption, Causation ot. Baker, H. B., M. D. 

Consumption, Extent and Distribution of in New Hampshire. Watson, Irving A., M. D. 
Consumption, The Preferable Climate for. Dennison, Charles, M. D. 
Consumption, The Prevention of. Clark, A. Arnold, M. D. 
Contagion, A Possible Source of. Merz, Charles H., M. D. 
Contagious Diseases, Should not the National Government Defend our Ports Against ? 

Lee, Benjamin, M. D. 
Contagious and Infectious Diseases, Rules for Checking, Bryce, Peter H., M. D. 
Cooking, The Art of, Atkinson, Edward, L L. D. 
Cotbeau, Buegenius, M. D., Medical Archaeology ; The sanitary regulations of ancient 

Egypt and Judea. 
Corlett, William Thomas. Prairie Itch, A clinical study of the so-called. Notes on 

the treatment of syphilis. A few suggestions on the diagnosis and treatment of 

lupus. Notes on the communication of disease. Diseases of the skin associated 

with derangements of the nervous system. 
Corrosive Sublimate as a Germicide. McClintock, Charles T., M. D. 
Corneal Transplantation from Rabbits to the Human Eye, A Case of. Smith, W. F., M. D. 
Cornwall County Council. (England) Reports. 

Covington Reservoir, Final Report of the Trustees of- Bouscaren, G. 
Cremation, Hygienic Argument for. Stone, A. K., M. D. 
Croton Water Supply, Sanitary Inspection of. Cheesman, T. M., M. D. 
Cretcher, W. H., M. D. Annual Address, Ohio State Board of Health. 
Currier, Charles G., M. D. Self Purification of Flowing Water and the Influence of 

Polluted Water in the Causation of Disease. 



l82 . ANNUAL REPORT 

Dairy and Food Commissioner, Chemist's report of adulterated articles. (Ohio.) 

Davenport (Iowa) Water Company, A description of the plant of. Donohue, Jas. P. 

Davis, Floyd E. M., Ph. D. The Purification of Water. 

Dennison, Charles, M. D, The Preferable Climate for Consumption, 

Denton, Prof. E. J. Trap Siphonage and Trap Seal Protection. 

Department of Agriculture. A revision of the adult cestodes in cattle, sheep and allied 
animals. Additional investigations concerning some swine diseases. Keport of the 
Secretary, 1891. 

Detmers, Freda, B. Sc. The Comparative Size of Blood Corpuscles of Man and Domestic 
Animals. 

Devonshire, Easton. The Purification of Water by Metallic Iron. 

Diphtheria, Cause and Prevention of. Committee of the A. P. H. A. 

Diphtheria, Therapeutics of. Burghardt, Joseph, M. D. 

Disease, Injury and Death in American Workshops, The Prevention of. Ireland, 
George H.,M. D. 

Disease of the Skin Associated with Derangement of the Nervous System. Corlett, Wil- 
liam Thomas, M. D. 

Discussion of Dr. Vaughan's Paper. Holmes, Bayard, M. D. 

Disinfectants, Committee of the A. P. H. A. 

Disinfection, Reek's System. 

Disinfection of Dwellings by Sulphur Dioxide. Edson, Cyrus, M. D. 

Disinfection and Disinfectants. Committee of the A. P. H. A. 

Disinfection of Rags. Committee of the A. P. H. A. 

Disposal of the Dead, Sanitary. Beckwith, D. H., M. D. 

Disposal of Sewage of Isolated Country Homes, The. Gerhard, William Paul, C. E. 

Disposition of the Dead. Sanitary Entombment the Ideal. Treat, Chas. R. 

Dixon, Samuel G., M. D. Annual Address, Pennsylvania S. B. of H. 

Donohue James P. A Description of the Plant of the Davenport Water Company. 

Draining and Plumbing, Laws and Rules for in Chicago, Ills., 1889. 

Dried Beef, A Case of Poisoning from. Reed, R. Harvey, M. D. 

Drinking Water, Is it Dangerous? Hill, John W., C. E. 

Drunkenness, The Unexpected in. A Study of Inebriate Responsibility. Wright, T. L., 
M. D. 

Drugs, Analysis of. Tucker, Willis G., M. D. 

Dry Closets, Improved Wards System. 

Dyspepsia, So-called Functional. Page, R. C. M., M. D. 

Edson, Cyrus, M. D. Disinfection of Dwellings by Sulphur Dioxide. La Grippe and 

its Treatment. Defences Against Epidemic Diseases. 
Eggleston, E. R., M. D. Malaria ; its Origin and Cause as a Factor in the Production of 

Disease. 
Engle Sanitation and Cremation Co. The Fire Closet. 
Empiricism, The Necessity of More Stringent Measures to Suppress. Horton, Albert 

H., Esq. 
Epidemic Diseases, Defences Against. Edson, Cyrus, M. D. 
Epilepsy, Successful Results in the Treatment of. Inglis, David, M. D. 
Epithelioma, its Etiology, Diagnosis and Treatment. Ricketts, B. Merrill, M. D. 
Evans S. F., M. D. Annual Address, Pennsylvania State Board of Health. 
Evans Eli E., Judge. Opinion, D. N. Kelly vs. Columbus Board of Education. 
Everts Orpheus, M. D. Problems of Public Interest in Regard to the Insane. Insanity 

as Related to Civilization. Obligations of the Medical Profession to Society and the 

Insane. Asexualation as a Penalty for Crime and Reformation of Criminals. 
Evidence of the Affinity of the Polynesians and American Indians with the Chineee. 

Lobechied, R. W. 



OHIO STATE BOARD OF HEALTH. 183 

Eye and Nose, A Case Illustrating the Existence Between Diseases of. Clark, C. F., M. D. 
Eyesight, The Influence of School Life on. Conklin, W. J., M. D. 

Factory Inspectors of Illinois. Annual Keport, 1893. 

Factory Inspectors of Illinois. Special Report, 1893. 

Fall, Delos, M. D. School Life, also a Study of the Action of Alcohol on the Human 
Body. 

Falls, William Henry, M. D. In Memoriam. William Clendennin, M. D. 

Farmers' Institutes, Lectures Delivered in Ohio, 1886-7. 

Feeble-Minded, Papers and Dicussions on the Care of. 

Fever, Causes of in Liverpool, England. Taylor, J. Spofford, M. D. 

Fire Closet, The. Engle Sanitation and Cremation Company. 

Flick, Lawrence F., M. D. Practical Measures for the Prevention of Tuberculosis. 
Special Hospitals for the Treatment of Tuberculosis. Mode of Entrance of the 
Bacillus of Tuberculosis Into the System. Prevention of Tuberculosis. The Con- 
tagiousness of Phthisis. 

Floods at Johnstown, Pa. The Operation of the Board of Health in Consequence of. 

Food Adulteration, Circulars and Laws of Ohio Relating to. 

Food Material, The Right Application of Heat to the Conversion of. Atkinson, Edward, 
L. L. D. 

Foreign Bodies in the Air Passages. The Management of. Thorner, Max, M. D. 

Fuller, George W. Sand Filtration of Water. 

Funeral Directors' Association of North America. Proceedings of Annual Conference, 
1892. 

Funeral Directors' Association of Ohio. Proceedings Annual Conference, 1893. 

Gallinger, J. H. M. C. A National Sanitarium for the Treatment of Pulmonary Diseases 

Garbage and Refuse of Cities and Towns, The Destruction of by Cremation. Kilving- 
ton, S. S., M. D. 

Garbage and Waste, The Disposal of at the World's Columbian Exposition. Morse 
W. F. 

Gas Lighting and Gas Fitting, Notes on. Gerhard, William Paul, C. E. 

Gasoline, Dangers of. Kellogg, J. H., M. D. 

Gayle, V. W., M. D. Typhoid Fever. 

Gennessee River Storage Surveys, Report on, 1894. 

Gerhard, William Paul, C. E. Architecture and Sanitation. Notes on Gas Lighting 
and Gas Fitting. The Modern Rain Bath; The Disposal of the Sewage of Iso- 
lated Country Houses. The Sanitary Condition of Watch Hill, R. I. 

Gibier, Paul, M. D. Hydrophobia. 

Gout and its Production. Probst, C. O., M. D. 

Governor's Message, 1893, Ohio. 

Hall, Rufus B., M. D. Report of a Case of Extirpation of a Calculus from the Ureter 
by Combined Abdominal Lumbar Section. 

Hall, Willis W., M. D. Rachitis, with Osoetomy for Resulting Deformity. 

Hamilton, Charles A., M. D. Report of Operating on Hernias. 

Heating and. Ventilation of the State House, Augusta, Maine. 

Heating, Ventilation and Cooling. 

Healthy Homes and Food for the Working Classes. Vaughan, Victor C, M. D. 

Hernias, Report of Operating on. Hamilton, Charles A., M. D. 

Herrick, C. L., M. D. Pathology of a Case of General Paralysis. 

Hewitt, Charles N., M. D. Water analysis. Public Health a Public Duty. 

Hill, John W., C. E. Is Our Drinking Water Dangerous ? New Water AVorks for Cin- 
cinnati. Sewerage and Drainage. Sewage Disposal and Water Supply. 



i84 AANUAl. REPORT 

Hog Cholera, Results of Experiments with Inoculation for the Prevention of. Salomon' 
D. E., M. D. 

Hog Pen Nuisance. Hunter, George P., Esq. 

Holt, Joseph, M. D. The Quarantine System of Louisiana. Quarantine Control, State 
or National. Principles and Practices of Maritime Quarantine. The Introduction 
of Yellow Fever into Florida. 

Homan, George, M. D. The Physical Conditions of the Police Force of St. Louis. The 
Relation of Land Monopoly to Population and Health. Land Liberation as a 
Public Health Measure. Public Health and the Land Question. 

Horton, Albert H., Esq. The Necessity of More Stringent Measures to Suppress Empir- 
icism. 

Hospitals, Construction of. Beckwith, D. H., M. D. 

Hot Springs as a Summer Resort, The. Beckwith, D. H., M. D. 

Hough, Charles A., M. D. Medical Legislation. 

Howard, C. C, M. Sc. Report of an Examination of the Well Water of Columbus, Ohio. 

Hunter, George P., Esq. The Hog Pen Nuisance. 

Hunting Health and Bears. Reed, R. Harvey, M. D. 

Hurst, S. H. Circulars and Laws of Ohio Relating to Food Adulteration. 

Hydraulics of the Hemlock Lake Conduit, Rochester. N. Y., Water Works. Rafter, 
George W., C. E. 

Hydrophobia. Gibier, Paul, M. D. 

Hydrophobia, Inoculation for the Prevention of (Spanish.) Liceaga Edurado, M. D. 

Ice and its Impurities. Influence of in Disease. Beebe, H. E., M. D. 

Idiotic and Feeble-Minded Children, Provision for. Kerlin, I. N., M. D. 

Illinois, Message to Thirty-Sixth General Assembly. Oglesby, R. J., Governor. 

Illinois State Board of Health. Zymotic Diseases in Chicago. 

Imbeciles, Custodial Care of Adult. Kerlin, I. N., M. D. 

Imbecile, The Moral. Kerlin, I. N., M. D. 

Inebriety. Address to the American Society for the Study of. Mason, Lewis D., M. D. 

Indiana State Board of Health. Small-pox in Muncie, 1893. 

Infectious Diseases, Atmospheric Purification in Relation to. Prince, D., M. D. 

Infectious Diseases, Disinfection and Individual Prophylaxis Against. Sternberg, 

George M., M. D. 
Infectious Diseases, The Importation of into Liverpool, England. Taylor, J. Spofford, 

M. D. 
Influenza, An Analysis of the Statistics of 49,500 Cases of. Lee, Benjamin, M. D. 
Inglis, David, M. D. Successful Results in the Treatment of Epilepsy. 
Injury, A Singular Case of. Smith, W. F., M. D. 

Insane, Obligations of the Medical Profession to Society and. Everts, Orpheus, M. D. 
Insane, Problems of Public Interest Concerning. Everts, Orpheus, M. D. 
Insanitary Condition of State Capitol. New York, State Board of Health. 
Insanity as Related to Civilization. Everts, Orpheus, 1*1. D. 
Inaugural Address, New York State Medical Society. Suiter, A. Walter, M. D, 
Ireland, George H., M. D. The Prevention of Disease, Injury and Death in American 

Workshops. 

Jacobi, A., M. D. Non Nocese. 

Jenkins, William T., M. D. Report Health Officer Port of New Y'ork, 1893. 

Jewish Hygiene and Diet. Von Klein, Carl H., M. D. 

Johnson & Johnson. Modern Methods of Antiseptic Wound Treatment. 

Jones, W. W., M. D. The Sanitary Needs of Toledo, Ohio. 



OHIO STATE BOARD OF HEALTH. 1 85' 

■Kansas State Historical Society. Eeport, 1892. 

Kellogg, J. H., M. D. Dangers of (Jasoline. 

Kelly, S. W., M. D. The Profebsion of Medicine as fSketched from Outside and from 

Inside. 
Kelsey, Charles B., M. D. The Third Year Work in Diseases of the Kectum at the 

New York Post Graduate Hospital. Four Years' Work in Diseases of the Kectum 

at the New York Post Graduate Hospital. 
Kerlin, I. X., M. D. Provision for Idiotic and Feeble-Minded Children. The Moral 

Imbecile. Custodial Care of Adult Imbeciles. 
Kerosene. Eeeve, J. T., M. D. 
Kilvington, S. S., M. D. The Destruction by Cremation of Garbage and Refuse of 

Towns and Cities. 
Klebs, E., M. D. The Treatment of Tuberculosis with Tuberculocidin. 
Knight, Frederick I., M. D. Medical Facts Concerning Colorado Springs. 
Koch, Robert, M. D. A Further Communication on a Cure for Tuberculosis. 

Lachrymal Duct, An Operation for Radical Cure of Stricture of. Thomas, C. H., M. D* 

La Grippe and its Treatment. Edson, Cyrus, M. D. 

La Grippe Epidemic with Treatment. Bradley, George B., M. D. 

Land Drainage and Obstructions to Water Courses. Reeve, J. T., M. D. 

Land Liberation as a Public Health Measure. Horn an, George, M. D. 

Laparotomy, Rectal Structure of Puerperal Origin Relieved by. Scott, N. Stone, M. D. 

Laparotomies, ICO Completed. Sutton, R. Stansbury, M. D. 

Larynx, The Removal of Foreign Bodies From. Thorner, Max, M. D. 

Latrines of the East. Morse, Edward S. 

Lee, Benjamin, M. D. Responsibility of the National and State Governments for the 
Protection of the Public Water Supply. Should not the National Government 
Defend our Ports Against the Common Enemy, Contagious Disease? The Disposal 
of the Sewage of Public Edifices. Extracts from Remarks Made Before the State 
Sanitary Association at Pittsburgh, Pa. Injuries to the Sacro-iliac Junction. A 
Brief History of Suspension in Pott's Disease. An Analysis of Statistics of 49,500 
Cases of Influenza. 

Legislation During 1893. Summary of. New York State Library. 

Leprosy in Minnesota, 1884-6. 

Leprosy in New Orleans. Blanc, Henry W., M. D. 

Leprosy, National Control of. Wyman, Walter, M. D. 

Liceaga, Edurado, M. D. Study of Yellow Fever in Mexico. Inoculation for the 
Prevention of Hydrophobia. (Spanish.) 

Life and Death Rates. New Orleans and Other Cities Compared. Chaille, Stan- 
ford E., M. D. 

Life Insurance, Medical Investigation in. 

Lincoln, Abraham. Memorial Address. Bancroft, George. 

Lincoln, D. F , M. D. The Sanitary Conditions and Necessities of School Houses and 
School Life. 

Lindsley, C. A., M. D. Physicians in Connecticut. 

Lobschied, Rev. W. Evidence of the Affinity of the Polynesians and American Indians 
With the Chinese. 

Local Government Board (England). Reports, 1889, 1890, 1891, 1892. Epidemic of 
Influenza. Enteric Fever in Tees Valley. 

Longevity and Climate. Remondino, P. C, M. D. 

Louisiana Slate Board of Health. Address of to People of Southern States and Mississ- 
ippi Valley. 

Lupus, A few Suggestions on the Diagnosis and Treatment of. Corlett, William 
Thomas, M. D. 



1 86 ANNUAL REPORT 

Malaria. Its Origin and Cause as a Factor in the Production of Disease. Eggleston. 

E. R., M. D. 
Malaria, and the Causation of Intermittent Fever. Baker, H. B., M. D. 
Maritime Quarantine. Laws and Regulations for in the United States. 
Maritime Sanitation in use at the Charleston, S. C, Quarantine Station. 
Maritime Sanitation, Principles and Practices of. Holt, Joseph, M. D. 
Marine Hospital Service. Annual Report of Supervising Surgeon General, 1887, 1888, 

1891. 
Martin S. C, M. D. The Inoculation, Propagation and Preservation of the Virus of 

Animal Vaccine. 
Mason, Lewis D., M. D. An Address to the American Society for the Study of Inebriety^, 
Massachusetts Registration Report. Calkins, G. N., M. D. 

Massachusetts State Board of Health. Guide to Exhibit at World's Columbian Expo- 
sition. Examination of Spring Water Offered for Sale in Massachusetts. 

McClellan, E. S., M. D. The Sewer Gas Question. 

McGee J. Preston, M. D. Remarks on the Management and Treatment of Tuberculosis. 

Mead Daniel W., C. E. The Qualities of Water for Domestic Supply and Boiler use. 
Notes on the Hydrogeology of Illinois in Relation to Water Supply. 

Medical Legislation. Hough, Charles A., M. D. 

Medical Archaeology? The Sanitary Regulations of Ancient Egypt and India. Corbeau,. 
Buegenius, M. D. , 

Medical Societies, The Object of. Thorner, Max, M. D. 

Medicine, The Best Preliminary Education for the Study of. Stevens, Edward S., M. D. 

Merchant Marine. The Medical Supervision of. Taylor, J. Spofford, M. D. 

Merz, Charles H., M. D. A Possible Source of Contagion. 

Meteorological Bureau. Annual Report, 1890. 

Miami Valley Medical Association, Constitution and By-Laws of. 

Michigan, Proceedings Sanitary Conventions. Battle Creek, 1890; Charlevoix, 1890;: 
Centerville, 1891; Iron Mountain, 1891; Mecaunee, 1891; Niles, 1891; Hillsdale, 
1893; Menominee, 1894. 

Michigan State Board of Health. Guide to Exhibit World's Columbian Exposition. 

Milk Inspection in Cincinnati. Bange, Theo., M. D. 

Milk Vinegar and Petroleum, Report on the Inspection of. Holyoke, Mass. 

Miller T. Clarke, M. D. Relation of the Physician to Sanitation. Cholera Infantum. 

Mississippi River Quarantine Station. Disinfecting and Fumigating System at. Olli- 

phant, S. R., M. D. 
Missouri. Conference of Local Health Officers. 1887, 1888. 
Montizambert, F., M. D. Report on Quarantine and Public Health, 1891. Report on. 

St. Lawrence Quarantine Service, 1892, 1893. 
Morse, Edward S. Latrines of the East. 
Morse W. F. Disposal of the Garbage and Waste of the World's Columbian Exposi- 

Musser J. H., M. D. The Limitations and Powers of Therapeutics. Tuberculous Ulcer 
of the Stomach. Grave Forms of Purpura Ha^morrhagica. Whooping Cough ; It& 
Management and Climatic Treatment. The Dangers of Antipyretics in Typhoid 
Fever. 

National Academy of Sciences. Report, 1885. 

National Conference of State Boards of Health. Proceedings, 1886, 1889, 1893. 

Nervous Diseases, The Neurotic Proclivity or Modern Tendency to. Strong, Jamm, 

New England Kitchen, The Story of the. Abbott, S. W., M. D. 

New Hampshire State Board of Health. Report on the Burning of the Stratford County 
Asylum. 



OHIO STATE BOARD OF HEALTH. 1^7 

New York Aqueduct, Condition of. New York Board of Health. 

New York Board of Trade and Transportation. A National Quarantine System Essen- 
tial to the Safety of the People, 1893. 
New York State Board of Health. Insanitary condition of the State Capital. 
New York State Library. Annual report, 1891, 1892. 
Non Nocese. Jacobi, A., M. D. 
North Dakota, Eesources of. 
Nose, External surgery of. Ricketts, B. Merrill, M. D. 

Oberlin Water Works, Rules of. 

Obliteration of Congenital Pignaentations. Ricketts, B. Merrill, M. D. 

Oglesby, Richard J., Governor. Message to the General Assembly, IllinoiB. 

Ohio, Federal, State and County Officers, 1894. 

Ohio, Proceedings of Sanitary Convention, Warren, 1887. 

Ohio State Sanitary Association, Proceedings of, 1886, 1889. 

Olliphant, S. R., M. D. Disinfecting and Fumigating System at the Mississippi River 

Quarantine Station. 
Ontario Provincial Board of Health. Report on Disposal of Sewage. 
Ontario, Proceedings of Sanitary Convention, Woodstock, 1887. Report Meeting of 

Executive Health Officers' Association. 
Opinion, D. N. Kelley vs. Columbus Board of Education. Evans, Eli E., Judge. 
Operative Surgery, A Clinical Report of, in the Service of Dr. William Bull. Coley 

William B., M. D. 
Oxygen as a Distinct Remedy for Disease, and a Life Saving Agent in Extreme Cases. 

Catlin, A. M., M. D. 
Ozone, The Relation of to Disease. Baldwin, J. F., M. D. 

Page, R. C. M., M. D. Functional Dyspepsia, So-called. 

Paralysis, Pathology of a Case of. 

Passenger Coaches, Hygienic Condition of. Conn, G. P., M. D. 

Passenger Coaches, Sanitary Inspection of. Reed, R. Harvey, M. D. 

Peckham, George W. The Growth of Children. 

Pennsylvania, Proceedings of Sanitary Conventions, Philadelphia, 1886; Lewisburg, 

1888; Norristown, 1890. Extract From Remarks Made at Sanitary Convention at 

Pittsburgh. 
Pennsylvania Society for Prevention of Tuberculosis. How Persons Suffering From 

Tuberculosis can Avoid Giving it to Others. How to Avoid Contracting Tuber- 
culosis. 
Peter, Robert, M. D. Sepsis, with a Narration of a few Interesting and Instructive 

cases. 
Phthisis,. The Contagiousness of. Flick, Lawrence F., M. D. 

The Southwest and Mexico for. 
Photo-microgrophy. On the Best Technique for High Power. Rafter, George W., C. E. 
Physicians in Connecticut. Lindsley, C. A., M. D. 
Plasto-cosmetics in Surgury of the Face. Ricketts, B. Merrill, M. D. 
Plunkett, J. D., M. D. Vital Statistics. Vital Statistics in Tennessee. City Progress 

and Public Health. 
Poisoned Beef, Cheese and Ice Cream Reed, R. Harvey, M. I). 

Population and Health, The Relation of Land Monopoly to Homan, George, M. D. 
Port of New York, Report of Health Officer of. Smith, W. M., M. D. 
Port of New York, Report of Health Officer of, 1893. Jenkins, W. T., M. D. 
Porter, Dwight. Report on an Inspection of Tenement Houses in Boston, Mass. 
Post Graduate Hospital, New York. The Third Year's Work in Diseases of the Rectum 

Four Years' Work in Diseases of the Rsctum. Kelsey, Chas. B., M. D. 



1 88 ANiNUAL KEPORi 

Pott's Disease, A Brief History of Suspension in. Lee, Benjamin, M. D. 

Prairie Itct, A Clinical Study of the So-called. Corlett, W. T., M. D. 

Preventive and State Medicine. Schenck, W. L., M. D. 

Prince, D., M. D. Atmospheric Purilication in Relation to Infectious Diseases. 

Probst, C. d*, M. D. The Physical Results of Mental Forces, or Action of Mind on Body. 

The Prevention of Tuberculosis. Gout and its Production. 
Public Health, a Public Duty. Hewitt, C. N., M. D. 
Public Health and Some of the Inconsistencies of the National Government. Suiter, A. 

Walter, M. D. 
Public Health and the Land Question. Homan, George, M. D. 
Public Health, Governments aids to. AVyman, Walter, M. D. 
Public Health Work in Villages, A. Plea for. Baker, H. B., M. D. 
Public Instruction. Annual Report of Superintendent, Washington, 1893. 
Public Instruction. Annual Report of Superintendent, Oregon, 1891. 
Public Schools in Relation to the Health of the Pupils. Reeve, J. T., M. D. 
Pulmonary Diseases, National Sanitarium for the Treatment of. Gallinger, J. H., M. C 
Pulmonary Tuberculosis. The Climate of North Carolina in re. Von Rusk, Karl, M. D, 
Pure Food Convention, Proceedings of National. 
Purpura Hemorrhagica, Grave Forms of. Musser, J. H., M. D. 

Quarantine. A National System Essential to the Safety of the People. 

New York Board of Trade and Transportation. 
Quarantine and Public Health, 1891. Mdntizambert, F., M. D. 
Quarantine Control, State or National. Holt, Joseph, M. D. 
Quarantine Inspection at New Orleans. 

Quarantine Service on the St. Lawrence. Montizambert, F., M. D. 
Quarantine Station at Sliimoneski, Japan. 
Quarantine System of Louisiana. Holt, Joseph, M. D. 
Quarantine System of the St. Lawrence, 1893. Bryce, Peter H., M. D. 
Quarantine Inspection of Atlantic and Gulf Coasts. Ranch, J. H., M. D. 
Quarantine at New Orleans, San Francisco and Victoria, B. C. (French.) 
Quarantine, National, Maritime and Interstate. Thornton, G. B., M. D. 
Quarantine Conference held in Montgomery, Ala., 1889, Proceedings of. 
Quarantine. Report on St. Lawrence, 1893. Montizambert, F , M. D. 

Rachitis with Oseotomy for Resulting Deformity. Hall, Willis W., M. D. 

Rafter, George W., C. E. Some Recent Advances in Water Analysis, and the Use of the 
Microscope for the Detection of Sewage Contamination. The Hydraulics of the 
Hemlock Lake Conduit of the Rochester, N. Y , Water Works. Report on an 
Epidemic of Typhoid Fever at Springwater, N. Y., 1889. Volvox Globator as the 
Cause of the Fishy Taste and Odor of the Hemlock Lake Water in 1888. Filtration 
of Sewage. Fresh Water Algae and their Relation to the Purity of Public Water 
Supplies. Measures for Restricting the L^se and Waste of Water in Force in 
Rochester, N. Y. On the Best Technique for High Power Photo-micrography. 
Biological Examination of Potable Water. On the Use of the Amplifier. 

Railroads and Telegraphs, Codification of Laws Relating to. (O.) 1893. 

Rain Bath, The Modern. Gerhard, William Paul, C. E. 

Bauch, J. H,, M. D. Inspection of Atlantic and Gulf Quarantine. Water Supply and 
Sewage Disposal of Chicago. Address in State Medicine. 

Raymond, Joseph H., M. D. Preparations of the City of Brooklyn for the Anticipated 
Epidemic of Cholera, 1884-5. Sulphur Fumigation in Cholera. 

Reed, M. C. Water Supply of the Drift Clay Land in Ohio. 

Eectal Surgery, Fifty Cases of. Ricketts, B. Merrill, M, D. 



OHIO STATE BOARD OF HEALTH. 1 89 

Keed, K. Harvey, M. D. Poisoned Beef, Cheese and Ice Cream. Sanitary Inspection of 
Passenger Coaches. The Healing and Ventilation of Schools and Churches in 
Mansfield, O. Water Supply of Mansfield, Ohio. Hunting Health and Bears. 
Case of Poisoning by Eating Dried Beef. 

Reeve, J. T., M. D. Kerosene. Land Drainage and Obstructions to Water Courses. 
Leprosy in Minnesota, 1S84-6. Our Public Schools and Their Eelation to the 
Health of the Pupils. 

Remondino, P. C, M. D. Longevity and Climate. 

Report of a Case of Extirpation of a Calculus from the Ureter by Comined Abdominal 
Lumbar Section. Hall, Eufus B., M. D. 

Resuscitation of the Drowned. Bush, L, P., M. D. 

Rheumatic Throat Afifections. Thorner, Max, M. D. 

Rhode Island State Board of Health, Nomenclature of Causes of Death. 

Richards, J. K., Attorney General. Compulsory Education in Ohio. Brief for Defend- 
ant in Error. 

Ricketts, B. Merrill, M. D. Plafeto Cosmetics in Surgery of the Face. Report of a 
Case of Tapes Equino Varus. The Early Removal of Tubercular Foci from the 
Bone. The Use of Arsenic in Dermatology. Epithelioma ; Its Etiology, Diagno- 
sis and Treatment. Excision of the Hip Joint in Tubercular Diseases. External 
Surgery of the Nose. Fifty Cases of Rectal Surgery. Obliteration of Congenital 
Pigmentations. One Hundred and Fifty Circumcisions and Lessons They Teach. 

Rupture of the Uterus. Tate, Magnus, A., M. D. 

Salomon, D. E., M. D. Results of Experiments with Inoculation for the Prevention of 

Hog Cholera. 
Sacramental Cup (The). Vanderwerken, A. 

Sanitary Drainage, An Economical System for City and Country. Wadien M. 
Sanitation. Relation of the Physician to. Miller, T. Clarke, M. D. 
Sanitarium, Medical and Surgical. Battle Creek, Michigan. 
Sacro- Iliac Junction, Inquiries to. Lee, Benjamin, M. D. 
Schenck. W. L , ^I. D. Preventive and State Medicine. 
School Houses. Chittenden, T. W. 
School Houses and School Life, The Sanitary Conditions and Necessities of Lincoln 

D. F., M. D. 
School Houses and Churches in Mansfield, O., The Heating and Ventilation of Reed 

R. Harvey, M. D. * ' 

School Hygiene. New York State Board of Health. 
School Hygiene, also a Study of the Action of Alcohol on the Human Body Fall 

Dei OS, M. D. 
School Hygiene, and What the Teacher can do to Promote it. Chittenden T. W. 
Scriven, G. R., M. D. The Quality of Man's Being. 

Scott, N. Stone, M. D. Rectal Stricture of Puerperal Origin Relieved by Laparotomy. 
Sedgewick, W. T., M. D. Typhoid Fever in Chicago, 111. 
Sepsis, with a Narration of a few Interesting Cases. Peter, Robert, M. D. 
Sewage Disposal and Water Supply. Hill, John W., C. E. 
Sewage Disposal at Canton, Ohio. Chapin, L. E., C. E. 
Sewage Disposal at the State Homeopathic Asylum for Insane at Middletowa N. Y. 

Report. 
Sewage Disposal, Improved Method for. Chancellor, C. W., M. D. 
Sewage, Disposal of. Committee Ontario Provincial Board of Health. 
Sewage, Disposal of. West System. 
Sewage, Filtration of. Rafter, George W., C. E. 
Sewage of Public Edifices, The Disposal of. Lee, Benjamin, M. D. 
Sewerage and Drainage. Hill, John W., C. E. 



190 ANNUAL REPORT 

Sewerage System, The New Orleans. 

Sewer Commission of Canton, Ohio. Report of. 

Sewer Commission of Oberlin, O. Report of. 

Sewer Gas Question (The). McCIellan, E. S,, M. D. 

Sewers. Worcester, Mass. Report of Committee 1890. 

Sewers for Small Towns. Staley-Cady. 

Sewers and Sewer Gases. Beckwith, D. H., M. D. 

Shock. Brush, L. P., M. D. 

Small-Pox in Muncie, Indiana, 1893. Indiana State Board of Health. 

Small-Pox Cases and Their Treatment During the Outbreak in Buffalo, N. Y. Clark^ 
Edward, M. D. 

Smart, Charles, M. D. Sanitary Water Analysis for the Detection of Recent Sewage. 

Smith, J. Lewis, M. D. Summer Complaints of Infants and Children. 

Smith, W. F., M. D, Case of Corneal Transplantation from Rabbits to Human Eye. A 
Singular Case of Injury. ^ 

Smith, William M, M. D. Report of Health Officer, Port of New York, 1892. 

Some Neuroses of the Menoplasm. Conklin, W. J., M. D. 

Southern Cattle Plague and Yellow Fever. Billings, John S., M. D. 

South Dakota, Resources of. 

Spring Water Offered for Sale in Massachusetts, Examination of. Massachusetts 
State Board of Health. 

Staley-Cady. Sewers for Small Towns. 

State Medicine, Address in. Rauch, John H., M. D. 

State Medicine, Recent Advances in. Baker, H. B., M. D. 

Sternberg, George M., M. D. Disinfection and Individual Prophylaxis Against Infec- 
tious Diseases. 

Stevens, Edward S. M. D. The Best Preliminary Education for the Study of Medicine. 

Stone, A. K., M. D. Hygienic Argument for Cremation. 

Straight, Howard S., M. D, Apex Catarrh. 

Stratford County Asylum, Report on the Burning of. New Hamphshire State Board 
of Health. 

Strawn, J. B., C. E. Improvement and Protection of Domestic Water Supplies. 

Strong, Jamin, M. D. The Neurotic Proclivity or Modern Tendency to Nervous 
Diseases. 

Suiter, A. Walter, M. D. Public Health and Some of the Inconsistences of the Na- 
tional Government. Inaugural Address. New York State Medical Society. 

Summer Complaints of Infants and Children. Smith, J. Lewis, M. D. 

Surgeon-General of the Army. Reports 1890, 1891, 1893. 

Surgical Operations, The Importance of Cleanliness in. Surgical Operations, A Re- 
sume ot. Allen, Dudley P., M. D. 

Sutton, R. Stanbury, M. D. One Hundred Completed Laparotomies. 

Swine Plague. Billings, John S., M. D. 

Syphilis, Notes on Treatment of. Corlett, W. T., M. D. 

Tapes Equino Varus. Report on a Case of. Ricketts, B. Merrill, M. D. 

Tate, Magnus A., M. D. Rupture of the Uterus. 

Taylor, J. Spofford, M. D. The Importation of Infectious Diseases into Liverpool 

England. The Medical Supervision of the Merchant Marine. Causes of Fever in 

Liverpool, England. 
Tenement Districts of Boston, Mass. Report on an Inspection of. Porter, Dwight. 
Therapeutics, The Limitations and Powers of. Musser, J. H., M. D. 
The Physical Condition of the Police Force of St. Louis, Mo. Homan, George, M. D. 
The Physical Results of Mental Forces, or the Action of Mind on Body. Probst 

C. O., M. D. 



OHIO STATE BOARD OF HEALTH. I9I 

The Profession of Medicine as Sketched from Inside and from Oatsid*. Kelley 
S. W., M. D. 

The Quality of Man's Being. Scriven, G. K., M. D. 

Thomas, Charles, M. D. An Operation for Radical Cure of Stricture of the Lach- 
rymal Duct. 

Thorner, Max, M. D. Kheumatic Throat Affections. The Management of Foreign 
Bodies in the Air Passages. The Object of Medical Societies. The Removal of 
Foreign Bodies from the Larynx. Thrush of the Pharynx and Nose, in an Adult 
Occurring During an Attack of La Grippe. 

Thornton, G. B., M. D. National Maritime and Interstate Quarantine. 

Thrush of the Pharynx and Nose, in An Adult Occurring During an Attack of La 
Grippe. Thorner, Max, M. D. 

Toledo, O., The Sanitary Needs of. Jones, W. W., M. D.' 

Trap Siphonage and Trap Seal Protection. Denton, J. E., M. D. 

Treat, Rev. Charles. Sanitary Entombment the Ideal Disposal of the Dead. 

Tubercular Diseases, Excision of the Hip Joint in. Ricketts, B. Merrill, M. D. 

Tubercular Foci. The Early Removal of, from Bone. Ricketts, B. Merrill, M. D. 

Tuberculosis. How Persons Suffering from, can Avoid Giving it to Others. Pennsyl- 
vania Society for Prevention of Tuberculosis. 

Tuberculosis, Special Hospitals for Treatment of. Flick, Lawrence F., M. D. 

Tuberculosis, Practical Measures for Prevention of. Flick, Lawrence, M. D. 

Tuberculosis, Mode of Entrance of the Bacillus into the System. Flick, Lawrence 
M. D. 

Tuberculosis, How to Avoid Contracting. Pennsylvania Society for the Preven- 
tion of Tuberculosis. 

Tuberculosis, The Prevention of. Probst, C. O., M. D. 

Tuberculosis, The Treatment of with Tuberculocidin. Kleebs, E., M. D. 

Tuberculosis, A Further Communication on a cure for. Koch, Robert, M. D. 

Tuberculosis, Remarks on Some of its Manifestations and Treatment. McQee, J. 
Preston, M. D. 

Tuberculosis, Its Prevalence, Communicability and Prevention. Wation, Irving A., 
M. D. 

Tuberculous Ulcer of the Stomach. Musser, J. H., M. D. 

Tucker, Willis G., M. D. Analysis of Drugs. 

Typhoid Fever. The Danger of Antipyretics in. Musser, J. H., M. D, 

Typhoid Fever in Chicago, Ills. Sedgewick, W. T. 

Typhoid Fever, The Etiology of. Wise, S. P., M. D.; 

Typhoid Fever, Gayle, V. W., M. D. 

Typhoid Fever, A Recent Outbreak in Waterbury, Conn. 

Typhoid Fever, Report on an Endemic at Springwater, N. Y., 1889. Rafter 
George W., C. E. ' 

University of Nebraska. Bulletins 19, 21, 25, 27, 31, 82, 33, 34, 35, 39. 

Vaccination. Beckwith, D. H., M. D. 
• Vanderwerken, A. The Sacramental Cup. 

Van Rensselaer, Howard, M. D. Impure Air and the Ventilation of Private Dwellings. 
Variola and Vaccina. 

Vaughan, Victor C, M. D. Healthy Homes and Food for the Working Classes. 
Venereal Diseases Amongst Horses in the County of Kent, Ontario. Report on Brvee 
Peter H., M. D. ' 

Vital Statistics, Registration of, in Michigan. Wilbur, C. L., M. D. 
Vital Statistics, Plunkett, J. D., M. D. 
Vital Statistics in Tennessee. Plunkett, J. D., M. D. 



I 92 ANNUAL REPORT. 

Volvox Globator as the Cause of the Fishy Taste and Odor of the Hemlock Lake Water 

in 1S88. Kafter, George W., C. E. 
Von Bibber, W. C, M. D. The Quarantine of the Future Yellow Fever. Prevention 

of Yellow Fever in Florida and the South. 
Von Klein, Carl H., M. D. Jewish Hygiene and Diet. 
Von Ruck, Karl, M. D. The Climate of North Carolina in re Pulmonary Tuberculosis. 

Wadien, M. An Economical System of Drainage for City and Country. 

Warming and Ventilation for Schools, Churches and Court Houses. 

AVaste and Garbage, The Cremation of. Carrothers, M. M., M. D. 

Watch Hill, R. I., The Sanitary Condition of. Gerhard, William Paul, C. E. 

Water Analysis and the Use of the Microscope for the Detection of Sewage Contamina- 
tion. Rafter, George W., C. E. 

Water. Sand Filtration of. Fuller, George W. 

Water (Self Purification of Flowing) and the Influence of Polluted Water in the Causa- 
tion of Disease. Currier, Charles G., M. D. 

Water Supplies, Improvement and Protection of Domestic. Strawn, J. B., C. E. 

Water Supplies, Pollution of. Committee A. P. H. A. 

Water Supplies, Responsibility of the National and State Governments for the Protec- 
tion of. Lee, Benjamin, M. D. 

Water Supplies, Fresh Water Aegae and their Relation to the Purity of. Rafter, 
George W., C. E. 

Water, The Qualities of for Domestic Supply and Boiler use. Mead, Daniel W., C. E. 

Water, The Purification of. Davis, Floyd, Ph. D. 

Water, The Purification of by Metallic Iron. Devonshire, Easton. 

Water Supply of Washington, D. C. Acting Secretary of War. 

Water Purification. Hyatt System. 

Water Supply of Cities. Ward, R. H., M. D. 

Water Analysis. Hewitt, C. N., M. D. 

Water Supply of Drift Clay Lands in Ohio. Read, M. C. 

Water Supply of Mansfield, O. Reed, R. Harvey, M. D. 

Water Supply and Sewage Disposal of Chicago, Ills. Rauch, John H., M. D. 

Water Works for Cincinnati, O. Hill, John W., C E. 

Wathien, W. H., M. D. Results of Asceptic Celiotomy. 

Ward, R. II., M. D. Water Supply of Cities. 

Watson, Irving A., M. D. Tuberculosis ; its Prevalence, Communicability and Preven- 
tion. Consumption ; Extent and Distribution of in New Hampshire. 

Well Water of Columbus, O., Report of an examination of. Howard, C. C, M. Sc. 

Whooping Cough, its Management and Climatic Treatment. Musser, J. H., M. D. 

Wilbur, C. L., M. D. Registration of Vital Statistics in Michigan. 

Wilson, Hector McLean, M. D. Cottage Sanitation. 

Wise, S. P., M. D. The Etiology of Typhoid Fever. 

Wooster University, Address at the Opening of the Medical Department of. Baker,^ 
Albert R., M. D. 

World's Columbian Exposition. The Bureau of Hygiene and Sanitation. Disposal of 
the Garbage and Waste of. Massachusetts State Board of Health Exhibit. 
Michigan State Board of Health Exhibit. 

Wright, T. L , M. D. The Unexpected in Drunkenness : A Study of Inebriate 
Responsibility. 

Wyman, Walter, M. D. Government Aids to Public Health. National Control of 
Leprosy. Address in re a Proposed Bill to Establish a Bureau of Health in the 
Department of Agriculture. 



OHIO STATE BOARD OF HEALTH. 193 

Yellow Fever, A Letter Upon the Causes of the Introduction of in Florida. Holt, 

Joseph, M. D. 
Yellow Fever and Southern Cattle Plague. Billings, John S., M. D, 
Yellow Fever, A Study of. Liceaga, Eduardo, M. D. 

Yellow Fever, The Quarantine of in the Future. Von Bibber, W. C, M. D. 
Yellow Fever, The Prevention of in Florida and the South. Von Bibber, W. C, M. D. 
Yellow Fever, A Letter Upon the Introduction of into Florida. Holt, Joseph, M. D. 
Yonkerman, D. P., V. S. Beef Inspection as a Part of Public Hygiene. 

Zymotic Diseases in Chicago, Ills. Illinois State Board of Health. 

PERIODICALS. 

American Analyst. New York, N. Y. Discontinued. 
' Annals of Hygiene. Philadelphia, Pa. 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894. 

British Medical Journal. London, England. 1888, 1889, 1890, 1891, 1892, 1893, 18M. 

Cincinnati Medical Journal. Cincinnati, O. 
Cleveland Medical Gazette. Cleveland, O. 

Doctor of Hygiene. New York, N. Y. Discontinued. 

Engineering News. New York, N. Y. 

Florida Health Reports. Jacksonville, Fla. 

Imperial Board of Health Reports (German). Berlin, Germany, 
Iowa MoQihly Bulletin. Des Moines, Iowa. 

Journal de Medicine et de Chirurgie (French). Paris, France. 
Journal of the American Medical Association. Chicago, Ills. 

Lancet and Clinic. Cincinnati, O. 

La Medicma Cientitica (Spanish). Mexico, Mexico. 

La Saluta Publica (Italian). Perugia, Italy. 

Medical and Surgical Reporter. New York, N. Y. Discontinued. 
Minnesota, Public Heahh. St. Paul, Minn. 

Modern Medicine and Bacteriological Review. Battle Creek, Michigan. 
Mother's Nursery Guide. New York, N. Y. Discontinued. 

National Popular Review. San Diego, Ca!. 

Norih Carolina. Bulletin of Board of Health. Raleigh, N. C. 

Philadelphia PcjJvc inic. Philadelphia, Pa. 

Popular Science Monthly. New York, N. Y. Discontinued, 

Rhode Island Monthly Bulletin. Providence, R. I. ' 

Sanative Me.licine. Westerville, O. 

Sanita y Ab-trac s. Marine Hoipital Service. Washington, D. C. 

1 i ST. B. II. 



194 ANNUAL REPORT. 

Sanitary Era. New York, N. Y. Dibcontinued. 

Sanitary Engineer. New York, N. Y. Discontinued. 

Sanitary Inspector. Augusta, Maine. 

Sanitary Journal. Glasgow, Scotland. 

Sanitary News. New York, N. Y. Discontinued. 

.■Sanitary Record. Columbus, O. Discontinued. 

rSanitary Record. London, England. 

•Sanitary Volunteer. Richford, Vt. Discontinued. 

.Science. New York, N. Y. Discontinued. 

Tennessee State Board of Health Bulletin. Nashville, Tenn. 
•Texas Sanitarian. Austin, Texas. 
'The Sanitarian. Brooklyn, N. Y. 

Veterinary Magazine. Philadelphia, Pa. 



ABSTRACT OP REPORTS 



-. OF 



Deaths and their Causes 



IN THE FOLLOWING CITIES AND 
TOWNS IN OHIO 



... FOR THE ... 



YEAR ENDING DECEMBER 31, 1894. 



OJIIO STATE BOARD OF HEALTH. 



197 



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14.36 
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21.'29 
15.26 
11.81 

1313 
12.93 
15.70 
16.45 

15.45 
1681 
16.62 
7.15 
10.15 
10.75 
15 54 
16.35 
15.89 
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15,981 
13,473 
10,092 
14,270 
12,394 
18,471 
31,895 
18,394 
10,801 
81,434 
33,2'20 
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1 


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Akron 

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Cincinnati 

Cleveland 

Columbus 

Dayton 

East Liverpool.. 

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Hamilton 

Ironton 

•Lima 

Mansfield 

Massillon 

Newark 

Portsmouth 

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Toledo 

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Zanesville 


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198 



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: : : : : : : : : : : : : • : 1 oi 


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'OOO'I Jad 91«J iBnuny 


11.04 
16 91 
18.07 

20.42 
10U8 
1.41 

13.34 
15.31 

12.70 

15.85" 
11.52 

8.97 
25 89 
20 00 
17.16 

5.08 

8.30 
10.68 

8.68 

12.51 
10 96 
25 15 

14.20 


6f 

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paptnaxasqutq 
-niJs pnB aaniBtaaij 
•sasnBD TIB sqiuao jwaox 






0681 snsuaa 'uonBindoj 


7,607 
9 934 
5 974 
6„556 
7 694 
8,224 
7,141 
7,070 
6,32 i 
4,498 
5,473 
5,557 
7,fi55 
8,273 
8,327 
6,250 
9,361 
6.0^7 
7,195 
9090 
4,726 
5,780 

4 494 
6,510 
5,973 
5,742 
4.377 
5,. '47 

5 901 
7 301 




M 

o 
a. 


Cities of less 
than 10,000 
inhabitants. 


Alliance 

Bellaire 

Buoy rut. 

' Circleville 

-defiance 

Delaware 

Fremont 

Fostorla 

Gallon 

Gallipolis 

Greenville 

■^'Kenton ,.... 

Lancaster 

''Marietta 

Marion 

Martin's Ferry.. 

Middletown 

Mt. Vernon 

Norwalk 

Piqua 

Pomeroy 

Salem 

Troy 

Urbana 

Warren 

Wash'gtonC. H. 

Wells ton 

WcUsville 

"Wooster 

•Xenia 


O 


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"000' I -lad a;Bj iBnuny 


13.91 

2338" 
21.62 
17.52 
13.88 
19.83 
30.66 

12 29 
17.07 
18.64 

ifi.oV 

13 07 
10.93 
20.33 
11.04 
16.92 
17 22 
15 55 
18.4 i 

9.39 
10.18 

19 89 




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1 




'0681 snsnao uoiiBindoj 


27.601 
26.189 
11,';88 
296,908 
261,3^3 
88,150 
61,220 
10 956 
18,553 
17,565 
10,9(9 
15,981 
13,473 
10,092 
14,270 
12 391 
18,471 
31,895 
13,394 
10 801 
81,134 
33,^20 
21,(09 

965,076 


01 


Cities of 10 000 

Inbabltauta 

(census 189u) 

or over. 


Akron,. 

"Canton 

Chllllcothe....' 

Cincinnati 

Cleveland 

Columbus 

Dayton 

East Liverpool 

FIndliiy 

Hamilton 

Ironton 

'•'Lima 

Mansfield 

MaKsillon 

Newark 

Horismouth ... 

Haudusky 

Springfleld 

8teubenville... 

Tiffin 

Toledo 

Youngstown... 
Zanesville 




o 

a 
2 



202 



ANNUAL REl'OKT 



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io-^r-< :cQc4'-< ; .-"T" : 



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•snoisxnAuoo 



s^linonoia 



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•Bixaidody 



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<ooi^ •^coeoT^ :ao^ :ic :>*«»-tcc-- iO-^c^ic^ccccwc^com 



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i-i'»eo ; 1-1 



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•qsnoo aaidooqM 



•jSAaj pioqd^x 



•siiinsnox 



•jaAaj idiaBog 



•aaAaj xBjaaaanj 



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'0681 sn8uaD'noi5Bindoj 






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° a 



OHIO STATE BOARD OF HEALTH. 



203. 



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1 1 H-*- ! M M : M : M i M h ! i liSf 




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:c^:toai(N*0::':;::;;:;:^H--Mto 
: : n — 1 ■■:■:■ : : : r lO 






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sasniBO we 'smuap iwiox 


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"0681 snsnsD 'noTj^indoj 


— 'CI oooc cooo toec i-r a> ^ "^ ^^o -^-^ic — -- — c OS 1 — 
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C^ C^l »- tTS to JO to — r^ '^ — i-> ,-' ,-' ^ ,-< r^ eo — ^ OO eo C^ Ci 


1 




Cities of 10,000 

inhabitants 

(census 1890) 

or over. 


Akron 

(anton 

Cincinnati 

Cleveland 

Columbus 

Dayton 

East Liverpool.. 

Findlay ... 

Hamilton 

Tronton 

Lima 

Mansfield 

'" vtassillon 

Newark 

Portsmouth 

Sandusky 

Springfifld 

StenbeiiviUe 

Tiffin 

Toledo 

Younestowii 

Zinecville 


c 


O 
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2 
o 



204 



ANNUAL REPORT 



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aasea 
-8ip iBinamdoiaAap ibjoj, 


•■^ • : I : : : 1 ; • :•-< i'^ I :=^ •'o : : :'^'^ : : : : : 


tc 


•Binorananj 


jcsTii : iiM : :iHoi : : : : .eoe<.-«r-) ;(N.-H--r-i .rr : : : : 


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siiiSataan 


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M h i i i ! li M i n i 


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cr. 


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MhhMl 


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hiMMil 


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s 


•siiBaoinind sisiqiqj 


:>-i.H : :c4e9i-irH :<-■ ji-i [e* '■eir-tdtoot :^ : 


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jrit-l : jOMrlfH jf-l jrH [Oi '.Mi-CCOtOIN ■<?< :i-lC4 j : : jj 


§5 


qanoo 3aidooqA\ 


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:::::::: 






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MM: 


: 


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iiMi 




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BHT2atnain |BUid9-ojqaJ30 
















•inniuvjni '8i3ioqo 






i- i 1 = i ! i 








- 


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,H j<.4 ': • • -^ -pH 








MM! 

: : : : : 


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•S99B39IP OJIOraiz IBJOX 


■-(i-li-i ;:•■•-';•-' 


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puB 8iB8i£ 8Ag Japan ibid,!. 


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?5 


OOO'T Jad aiBj iBnnuv 


7.88 
3.28 
4.06 

0.21 
0.08 
8.67 

10.67 
2.19 

6.35 


1.53 
!1.12 
8.97 
7.91 
167 
8.48 
7.56 
2.45 
6 70 
1.06 
0.54 
8.81 
3.70 
8.29 




•-••-t 




'^ 


■papnijxa sq^iiq 
-[HIS paB ajniTJcaajj 
•sasnwo hb 'sqiu^o iBiox 


tr5--t- • : t-- <o i-« cc -^ tH :-^ 

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00 -- t*0> t*-^ t^cOO» irtOi lOOO ■ • 


IH 


0681 8n9nao'aonB[ndo,i 


7,607 
9,934 
5,974 
6,556 
7,991 
8.224 
7,141 
7,070 
6,326 
4,498 
5,473 
5, .557 
7,,^55 
. 8 273 

250 
9,:!64 
6,027 
7,195 
9,090 
4,726 
5 780 
4,491 
6,510 
5,973 
5,742 
4,377 
5,247 
5,901 
7,301 

158,904 


.Sga 

ill 


am 


^■Circleville 

''Defiance 

Delaware 

Fremont 

Fostoria ,.... 

Gallon 

Uallipolls 


■2S.1 

a o I. 

' 1/ a K 


Marion 

Martin's Ferry.. 

MIdrtletowu 

Mt. Vernon 

Norwalk 




£•25 


•d : i : 1 

-.ai£ * o a 


gg 
O 



OHIO STATE BOARD OF HEALTH. 



205 



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1 


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5.974 
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6 326 
4.498 
5,473 
5,557 
7,555 
8,273 
8,327 
6,250 
9,361 
6,027 
7,195 
9,090 
4,726 
5,780 
4.494 
6 510 
5,973 
5,742 
4,377 

5 247 

6 901 
7,301 

1.^4.178 


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•43x:xi 


Alliance 

Bellaire 

Bucyrus 

-Cirolerille 

■Defiance 

Delaware 

Fremont. 

Fostoria 

Gallon 

Gallipolis 

Greenville 

'Kenton 

Laucasier 

-Marietta 

Marion 

Martin's Ferry. 
Middletowu .... 

Mt. Vernon 

Notwalk 

Piqua 

■Pomeroy 

Salem 

Troy 

I'rbana 

Warren 

Wa'h'gtonC. H 

Weliston 

Wellsville 

•'Woo.ster 

'■Xenia 




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OHIO STATE BOARD OF HEAL'ili. 



207 



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208 



ANNUAL REPORT 





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'24 85 
14.20 
26 57 
22.12 
35 76 
20.70 
15.48 
8 76 
9.05 
21.86 
14.26 
15 76 
14.25 

14.52 
6.49 
13.91 
1792 
17.77 
2166 
21.35 
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27,601 
26,1 h9 
1 ' .288 
296,908 
261,353 
88,150 
61,220 
10,9,'^ 6 
18,553 
17,565 
10,939 
15,981 
13,473 
10,092 
14 270 
12,394 
18.471 
31,895 
13,394 
10,801 
81,434 
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21,009 

1,097,061 




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East Ltveipool 

Fiiidlay 

Hamilton 

Ironton 

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Ponsmouth ... 

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Springfield 

Stpubenville... 
Tiffin 


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14 



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210 



ANNUAL REPORT 



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= M U ; M M M M M ! U M i 1 


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1 j- I : : U 


: U i M M M N = M M M j M^ 


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i ! i i ! 1 i-^ 


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i 1 i i-^ M 1 


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i"- 1 i"^ i : ?• 


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•- M N ! M 


- M ;.U M : : M ;J M N I M 1^ 


•ran^uBjui Biaiaqo 


CM 1 i :ti< j ic^—iM : :.-i io-^ ::•::—' ;— 'cmi-i :!N \ | j «a 


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h Mi- i ; M Mi N i N- Ml-I 


■sasBasip oiioniiCz ib'Jox 


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soio : : : : i i-trn : :■* : iiMr-i r^n : :m> iiNeoN to :<n 1 o 


"OOO'I -tad ajBJ iBnuny 


9.46 
12.08 
10.03 

'i5.12 
18.67 
18.96 
26.67 
10.96 

1*4.29 

'2'4.'49" 
17.26 

6.40 
13.93 

8.34 

'26.40 
15.57 
14,73 
18.08 
20.89 

25.15 

21,36 


lO 


papn[..x.< sqiaiq 
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— 1 


'0681 snsaao 'uoiiBindoj 


7,607 
- 9,934 
5,974 
6,556 
7,694 
8,224 
7,141 
7,070 
6,326 
4,498 
5,473 
5,557 
7,555 
8,273 
8,327 
6,250 
9,364 
6 027 
7,195 
9,f'90 
4,226 
5,789 
4,494 
6510 
5,973 
5,742 
4,377 
6,247 
5,901 
7,301 

143 ..'SI 9 


So «s 

Of od ^ 


Alliance 

Bellalre 

BuoyrUB 

•=Circleville 

Deliauce 

Delaware 

Fremont 

KoBtoria 


QftUipolis 

• Ireeuville 

Kenton 

lyaucaster 

■'Marietta 

Marion 

Martin's Ferry.. 

Middletown 

Mt. Vernon 

Norwalk 

•Piqua 

>Pomeroy 

Salem 

Troy 

llrbana 

Warren 

W.Hsh'gton C. H 

Wellston 

Wellsville 

Wooster 


XD 

1 



OHIO STATE BOARD OF HEALTH, 



311 



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puBSiTJaX a.vq japnn tb'Ot, 



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ANNUAL REPORT 



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7.89 
4.83 
2410 

11.76 
13.57 
15.18 
1068 
15.35 

"9.53 
9.43 

28 82 
9.59 
6.40 
7.96 

16.67 

15.23 
33.21 
16 02 
18.43 
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'2V.36 




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Defiance _ 

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Fremont 

Fostoria.'. 

Qalion 

Gallipolis 

Greenville 

-■Kenton 

Lancaster 

tMarietta 

Marion 

Martin's Ferry.. 

Middletown 

Mt. Vernon- 

Norwalk 

■Piqua 

Pomeroy 

Balem 

Troy 

Urbana 

Warren 

Wash'gtonC. H. 

■■'Wellston 

Wellsville 

•Wooster 

Xenia 


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OHIO STATE BOARD OF HEALTH. 



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16.74 
15.12 
15.94 
15.52 
19.42 
11.29 
16.85 
6.57 
12.29 
18.44 
7.68 
9.76 
14.25 

"7.*5*6 
8.71 
9.09 
12 01 
8.96 
13.33 
19.45 
19.50 
13.71 




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'0681 snsnao 'notiB^ndoj 


27,601 
2«,189 
11,288 
296,91)8 
201,353 
88,150 
61,220 
10,956 
18,.'^.53 
17,565 
10,939 
15,981 
13,473 
10,092 
14,270 
12 394 
18 471 
31,895 
13,394 
10,801 
81,434 
33,220 
21,009 




Cities of 10,000 

Inliabitants 

(census 1890) 

or over. 


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OHIO STATE BOARD OF HEALTH. 



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2 






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2 






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• ; l^-^ !•'-'::•::::: :-i ! :<N : .; 


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1 ; jco-i — "-<:':-< \ ■'. '.'^ ':': I [ l-*': I 


« 






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t~r- :«(N'd-* j-sxN"-! l-H :d ;;od rio-v :.-i 


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•33SB3S1P OTJOaiAZ IBIOX 


,-»oo«c>ooo-*d--t^int* :co :if3cot*i:^ :o<& id loo 






MBa^I aao j3ao 
pu« «;Bai aAij jouun jbjox 


icodoi^-^-o :>ow-<f< :,-i :dmiOr-i : ;coc^,-< -^ 






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17.82 
14.66 
9.57 
1790 
20 66 
16.60 
'?1.17 
10 95 
12.i9 
17.76 
18.65 

13.35" 

12.61 
13.55 
11.04 
15.05 

22 22 
15 32 
15.55 
12.56 


00 






•papnpxa sqiJiq 
^ -Tins puB ainiBoiaij 

•S3STIB0 ITB 'SqiTiap TBIOX 


,-< dO^ Cr»0 dOC Oa^l-COtrt lift'^t^O O-VCOd 

•<j>eo -windo— — ■d'-i rH :T-ir-(rt-9< .do-wd 









'0681 snsuao 'uonBindoj 


27,601 

26,189 

11,288 

296,908 

261,353 

61,220 
10 956 
18,;)53 
17 565 
10,939 
15,981 
1.^,473 
10,092 
14 270 

18,471 
31,895 
13,394 
10,801 
81434 
33,220 
21,009 




co' 



•6 




Cities of 10,000 

inhabitants 

(census 1890) 

or over. 


Akron 

Canton 

Chlliicothe 

Cincinnati 

Cleveland 

Columbus 

Dayton 

East Liverpool 

Finulay 

Hamilton 

Ironton 

Ijima 

Mansfield 

••'Massillon 

Newark 

PoriKmoutli ... 

Sandusky 

Springfield 

'.steubenville. 

Tiffin 

Toledo 

Youngstown... 
Zaaesville 


1 





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2 


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3l8 



ANNUAL REPORT 



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13.41 
13.29 
1S.08 
29.13 

'8.40 
10.18 
9.49 
24.01 
13.16 

iV.29" 
8.70 
12.97 
26.88 
20.51 
13.93 
11.67 
14.52 
5.08 
12.46 

ii'.oe 

12.06 
14.61 
13.70 

14.'79 






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2 




'0681 snsnao 'nojiBindoj 


7,607 
9,934 
5,974 
6,556 
7,694 
8,224 
7,141 
7,070 
6,326 
4,488 
5.473 
5,557 
7,555 
8,273 
8,327 
6250 
9,364 
6,027 
7,195 
9,090 
4,726 
5,780 
4,494 
6,510 
5,973 
5,742 
4,377 
5,247 
5,901 
7,301 

162,353 


•6 




Alliance 

Bellaire 

Bucyrns 

Circleville 

=■' Defiance 

^Delaware 

Fremont 

FoBtoria 

Gallon 

Gallipolis 

Grtenville 

•Kenton 

Lancaster 

Marietta 

Marion 

Martin's Perry.. 

Middletown 

Mt. Vernon 

Norwalk 

Piqua 

Pomeroy 

Salem 

-I'roy 

Urbana 

Warren 

Wash'gton C.H. 

WeDston 

Weilsviile 

-Woosier 

Xenia 


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OHIO STATE BOARD OF HEALTH . 



219 



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4.C5 
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2.75 
9.42 
3.34 
2.71 
.^33 
35 
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16 46 

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6 27 
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12.29 
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81,434 
33,220 
21,009 


to 

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Cid 




Cities of 10,000 

Inhabitants 

(census 1890) 

or over. 




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Canton 

Chillicothe 

Cincinnati 

Cleveland 

Columbus 

Dayton 

East Liverpool 

Findlay 

Hamilton 




Portsmouth 

Sandusky 

Springfield 

Sieubenvil^e ... 


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220 



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1 



OHIO STATE BOARD OF HEALTH, 



221 



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5,545 

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1,126 

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286 

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I>«iyton 

Ea«t Liverpool 

Findlay 

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lUma 

Mansfield 

fMassillon 

Newark 

Portsmouth 

BanduHky 

Ppringfield 

tt5teubenvillc.. 

Tiffin 

Toledo 


a : 

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o 


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o 

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222 



ANNUAL REPORT 



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OHIO STATE BOARD OF HEALTH. 



223 



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•snisumaw 1 M M i i r M M M M i MM" 


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■si|Tuo;uad puB spuiSBo j j j M : i : i'^ i 1 : M M • i i • M M J 


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•asBasip s.iqSua 


: I rH r-i :: (N ;: rt :::::::;::::::: : 


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•tatnuBjai Biaioqo , 1 • • : • • • • • • • • • • i • 


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1 ! : :.:.::::: : 


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puB 91V9A OAg lapnti tbiox 1 : : • = • • = ■ ■ \ ■ 


•iBav: auo Japan xBjox j 1 j" 1 I""" ! 1 ; " j ;^'=^ 


"OOO'I '8d s^^'i IBnnav 


5.77 
40.00 
36.06 
17.27 
13.63 
13.41 
15.73 
1003 
15.57 
37.50 
15.64 
19.23 
5.32 
71.00 
27.71 
7.62 
9.77 
3.70 
19.97 
18.32 
31.80 
31.83 
20.03 
24.24 
27.78 
30.74 


•papniaxa sqjJiq 
-inis p u B ainjBtuai<i 
•s.i8nB0 TIB 'sqiBap [bjot, 


rHC«^>J'C»«lO-<f<i-(i-lr-l-«<MrH-<rMr-li-tTHiH-<l<COMC<'VeCeO 


'0681 snsnaa 'noii^lidoj cj ^^oi'^m^ wrtci ^.-rireo" ciMrti^-rH^nH" 


Is 

bg 

<^ 


Ada 

Amelia 

Ashtabula 

Athens 

ATOiidale 

BcUevue 

Blanchester 

Bloomville 

Bourueville 

Brywn 

Caldwell 

Carthage 

Chester Hill 

Chl(ai;o 

Cliftoa.Ham.Co 

Clyde 

Coniieaut 

Cumberland 

Ctiyahoga Falls 

Delta 

Doylestown 

Elmwood Place. 

Elyria 

Fairport Hurb'r 



224 



ANNUAL REPORT 



U 






•squiq-xjijs pnv sin^vmsid 


"^ i"^ i : : i I : : : 1 : 1 i'^ :" I : : : i 1 1 i 


aonaioiA :«iox 


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-sip TBm^^^doI^A.^p ibiot 


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Binorananj 


; : : 1 i H 1 i-^-- 1 i i i i-^ i h M'" ;^ i 


•jtsunaij 




•sijiSninaw 


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■siijnojijdd puB snujsBO 


i M i M M M 1 i U h h H M M M 


•9no!S[nAnoo 


: M M : h i i M M U i i M M h M 


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': •■:::::::::■:•::::::■!:•: • 


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saiSHOK 




■sjaiaj iBiJB;KK 




■Xj.tiaasia 


::::::■::■:::::::::::::::• 


■sasBasip [Brt)qjjBia 


: I i i i : : I : : I : : : I : : : : I : ! : : I ! 


•snqjoin BjO[oqo 




•sni^aiuaui jBuias ojqajao 


i • M ! ; M M ^ : : = ; M M M h u! 


niniUBjai Bia[oqo 




•BijaqiqdTp pnB dnoin 


; ■ i H U M • U M i i n M i j 1 j M 


•sasueaip Diiouiiz ibjox 


: jiH jrH I : : : : ; . : ; : I I :,-i : : :,-i j,.^ : 


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poB 9JB9.C aAij japun imo i 


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M M M i i ; i M n i ■ :•- i 1 M H-^ 1 


OOO'X Jad aiB'i iBnnnv 


2131 

2294 

20.98 

6.85 

K.49 

27.77 

9.29 

9 70 

4.93 

26.^5 

' 12.11 

13.51 

72.29 

6.77 
95.62 
27.09 
1316 
.9.75 
32 65 

5.27 
10.95 
1346 

4 31 
10.66 

8.22 


•papnpxa sqjaiq 
nu^ P«B ajnjBinaij 
•aasnna tib 'sqiwap JBIOX 


dOi-KNN'Hr-lJje^C^.-He^rtCN.-TI'COlCrt.C-lt-liCrHTfCO 


0681 snsnao 'nonBindoj 


1,126 
1,046 

572 
3,501 
2,826 

432 
1,291 
2,474 
3,119 
4,863 

457 
1,965 

8S8 

332 
1,771 

502 
1,329 
4,558 
1,230 
1,470 
2,278 
1,096 
4,4.'i6 
2,782 
4,500 
4,376 


J3 ■ 

II 


Forest 

Garrettsville 

Kent 

Lcetonia 

Lexington 

Linwood 

Lockland 

Logan 

I/Orain 

Ijoramles 

Mnnc'liester 

McAriliur 

McCiure 

McConnelsville. 

Mentor 

Mt.Gilead 

Nelsonv lie 

NewLexiniiton. 
New Lisbon .... 

New Loudon 

N. Philadelphia 
N. Straitsville... 

Norwood 

Oberlln 



OHIO STATE BOARD OF HEALTH. 



225 



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ANNUAL REPORT 



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i i ; : : ; : i i ; i I'M ; : i i ; i 1 : i 


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■siaAaj t^BUBiBK 






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•snqioni BjaToqo 






•sniSainam iBnids-ojqaiao 






•niniUBjnt Bjaptio 






•■Biiaqiqdip puB dnoao 




• ; to ::::'::::—:-' I .••••: -^ ': 


■saseasip otiocniziBaox 




I i to r-( : tH -^ i : -* i ^ ?) ,-c : : : i .h. I -h : 


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puB sivdS. aATj jaonn ivjox 


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■r-t^ : :-» : i^-n : : : i : : : : i : :-^ i jeoca 


•000'l-iad8J'8-iI'«^°nV 


5.77 
20.00 
42.32 
18.18 
26.12 
1918 
18.47 
33.11 
11.50 

7.86. 
20.06 

18.18" 
17,30 
15.61 

5.32 
53.25 
18.47 

7.62 
53 62 
25 90 
26.14 
22.95 
1321 
36.36 
30.74 


•papnpxa sqiJiq 
-nias put! ainiTJinaJcj 
•sasuBD TIB sqiBop TBiox 


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'0681 susnao 'itoiiBiudoj 


ciO-^0'«aocoi-cO(Ntocrocor-.^i-jD^icr---'r^'t'<oo--< 

CS n-^^Qfi GOi-t r-4 CO r-i OTCO (N .— Ii-Hi— lCOCCCM»-*f-H»H 


Eighty-four 
villages. 




Ashland 

Ashley 

Ashtabula 

haiiibridge 

Be -ford 

Bellfviie 

Blanihester , 

Bloomville 

Bloomineburg.. 
B<i\vllng Green.. 

Bryau 

Carthage 

Chester Hill 

Chicago 

Clifton, Ham. Co 

Clyde 

Conneaut 

Co^liooton 

Cuyahoga Falls 
Ktist Palestine . 
Kim wood Place 
Fairport 



OHIO STATE BOARD OF HEALTH. 



227 





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376 

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Welliugton 

West Cairo 

West Liberty 

Weston 

WIlmiBgton 

Winton Place ... 
Wyoming 


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3,068 

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1,575 

2,327 

3,241 

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1,131 

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Clifton, Ham.Co 

Clyde 

Conneant 

Coshocton 

Cuyahoga Falls. 

Doylestown 

Elmwood Place. 

Fairport 

Frflclty 

FerMt..... ^.. 



230 



ANNUAL REPORT 



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1,046 
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2,141 
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1,143 
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2,474 
3,119 
4,863 
2,810 
1,771 
1,459 
1,923 
1,329 
4,558 
1,470 
2,278 
1,096 
2,782 
1,648 
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Hicksville 

Hubbard 

Hudson 

Huron 

Jamestown 

Kent _ 

Leetonia 

Lexington - 

Linwood 

Lockland 

Logan 

Lorain 

Marysville 

McConnelsville 
Mechanicsburg. 

Millersburg 

Mt. Gilead 

Nelsonville 

New Lexington 

New Lisbon 

New London 

NewStraitsville 
Nortb AmheTst. 
Norwood — 



OHIO STATE BOARD OF HEALTH. 



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40.00 
16.82 
57.84 
18.70 
18.78 
33.11 
23.03 
20.07 
42.90 
26 60 

7.62 
10 30 
25.91 
16 20 
36.72 
13.21 

6.06 
10.65 

8.35 

11.20 
8.01 
6.86 
12.66 
25 44 
27.77 

24.25 

7.70 

12 34 

46.60 


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Amelia 

Ashland 

Ashley _ 

Ashtabula 

Avondale 

Bainbridge... 

Bedford 

Bianchester 

Brou?hion 

Carthage 

Clifton Ham. Co 

Wyde 

Conneaut 

CoKhocton 

Cuyahoga Palls. 
East Pale.stine... 
Elm wood Place. 

Foreit 

Germantown ... 

Giiboa 

Glendale 

Hioksville 

Hubbard 

Kent 


La Rue 

Leetonia 

Lexington 

Liuwood 

LocKland 

Logan 

Lorain 

McComb 



OHIO STATE BOARD OF HEALTH. 



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.16.66 
9.28 
4 76 
15.78 
10.94 
8.62 
14 56 
13.33 
19.11 
25.20 
16 59 
20.23 
50 35 
12.37 

11.52 
16.24 
20.00 
1160 
19.45 
7.50 
8.25 


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1,965 
1.293 
2,518 
2.278 
1,096 
2,782 
1648 
4.500 
4,376 
3,103 
2,168 
1,779 
1,977 
4,850 
482 
1,041 
1,465 
1,20 > 
2.069 
3,079 
1.600 
1.464 

117,732 


Manchfster 

Montpelier 

MurrayOity 

New Lisbon 

Nt w London 

N. titraltsville .. 
North Amherst 

^<l^wood 

Oberlin 

Kt-adiiig 

Riverside 

8t. Bernard 

Shelby 

Kidney 

Smithville 

8 Oharleston ... 

Tippecanoe 

Wet.t Liberty ... 

Wellington 

Wilmington 

Wlnton Place... 
Wyoming 


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^(N,-H 1 1 i i i : i : : j i 1 ! I 1-^ • • : • :'-' i'^ : : !*• 1 


•BTuoninanj 




•isunaij 




•sutSuinan 


: i M li i n i i i 1 11 i i 1 ii r H i r 1 


•asBasip tJB3H 


: : jr-iiHiH : if-i : : : :i-i : : : ji-i : jrH ji-t : : : 


•snmoiiaad puB si^Wsbq 


M r M M M M M M M M i i M M f ^'^ 


snotainAuoo 


i-^ i i M i ; ! i i ! 1 M M i i 1 U i i i i ! i 


•sijiqanoja 


H r h M ! M M ! M i i M 1 M i M W 


•asBasip s.iqSiig 


U r J"" 1 i n M 1 M M M M r M 1 : 


•Bixajdodv 


r i M M M M M = N i i M M M M = = ^ 


•SaSBBSip IBOOl IB^OX 


rt-oi :toi-(e<irH :e»i-H : :t-(.-i,-i*H : jim^nm :h : ji-i cj ; 


- 1 


•sil^nonJind sisiq^qj 


rH .t-ir-i : : : :o : tr-i :-H : :i-i : I : : ;iH : : : : :« : 


•J90UB0 


1 j i i M M M i i'^" i M M i i r i M in 


83883 

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1-1 jiHrH ii-l ; JM j ji-lr-ie* ; JrH ; j 5 : '.O* • • j *< 


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::: i i :::::::: I :::::;'::::: :'-''H 




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: : : 


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1 M 1 i M M'^ H ! M M 1 M M M h 


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: : 


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! i i M i 1 H ; M i = M ! M M N : M 






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i ; i i i i i i ! 1 i i M i • ; : ; i M i ! ■ = 




■-^ 


•Ajaia39.ici 








•sasBasip iBaoqajBid 








•snqjOOT Biaioqo 


::;:::::::::::':::::: :::::: : 






smauinara iBuids-Ojqajao 


;*::::::::::::::::;;::::;;: 




'^ : 


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■Bjiaqiqdip puB dnoio 


• i i 1 M 1 i i i 1 ! H : i i-^ i 1 M = i i-^ j 




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•sasreasip oiioniiz ib^ox 


: : : itH :,-i,-4r-irH : : : : : • ,-i : : [-v : : :p)r-t-i :oiini-i 


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puB sjBa.4 aAg japnn ibjox 


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H M M i M M M M I M 1 M'' i M M 


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17.31 

12.95 

18.18 

18.78 

23.00 

11.46 

20.07 

18.80 

23.46 

10.63 

44.11 

7.61 

10.31 

9 80 

9.18 

10.60 

6.61 

6.06 

6.41 

10.24 

3\98 

35.18 

16.62 

16.70 

8.01 

1 21,20 

,9139 

1 4.25 

21.88 

' 12.18 

22.21 

i 16.72 


•papnioxa smajq 
-\\i19 puB aimBinajj 
•aasuBO iiB 'sqiBap iBaox 


eiJO>'Wr-NOOe*rH!OC^rHr-lCMeO<NrHrHrHeOr^NOOemNi-IC<eOrHeO-0>0>,-l 


•0681 snsuao 'noHBindoj 


2,079 
8,338 
2,640 
4,473 
1,043 
3,052 
1,196 

638 
3,068 
2,257 

272 
1575 
2 327 
3,672 
2,6:4 
1,131 
1,810 
1,980 
5,611 
1,171 

(i(i7 
2,729 
1,414 
1,437 
1,498 
1,132 

894 
2,826 
1,291 
3,119 
4,863 

763 


o 

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Ada 

Ashtabula 

Arondale 

Bedford 

Bellaire 

Blanche«ter 

Bloom ingburg.. 

Bryan 

Carthage 

Catawba 

Clifton, Ham.Co 

Clyde 

Cosh'x^ton 

Cuyahoga Falls 

DoyliiStown 

E**t PalCRtine . 
Klmwood Place 

Klyria 

Fairport 

Frankfort 

Franklin 

•ilendttle 

Germantown ... 

Hubbard 

Jeflersonvillri ... 
Junction City , 




i is? 

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OHIO STATE BOARD OF HEALTH. 



237 



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2 61 
23 05 
29.64 
22.87 
11.69 
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1,771 
1,965 
1.293 
4,558 
1,470 
2,278 
1,096 
4,456 
2,782 
4,500 
4,755 

487 
1,183 
3 103 
2,168 
1,080 

461 
1,977 
4.8,50 


i5 


4,585 
1,041 
405 
1,574 
3 079 
1600 


i. 


00 


McConnelgvlUe. 

Manchester 

Montpelier 

Nelsonville 

New Lexington 
New Lisbun .... 

New London 

N. Philadelphia 
NewStraitsville 

Norwood 

Painesville 

Port Wash'gton 

Plymouth 

Reading 

Riverside 

Sabiua 

SenPCHville 






South Brooklyn 

S. Charleston 

Thornvillc- 

Wad.s'.vorth 

Wilmingion 

Winton Place... 
Wyotuing 


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238 



ANNUAL REPORT 






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jci j : i j j ; j i :(M : : : : I i I : : : : :ct i : : j : : . 


'vmomnaad 


n h n M M M M MM HN H h M U li 


•Xsiinaij 


j M H i M M M i ; M M M : M i M M Mi 


•siiiSuynapi 


i M N i M M i i M M i i M h M M li M h 


'asB39}p ;i^3H 


jfH'H : : i : • : J'-i^h Jimi-hn ::::;:::: :,-i!n : | : ; 


•snino^ijad puB sijij'jaBf) 


i i i =-■ i = i ; :-' i i ; ;- ;- i i i : ; i^ i : : i ;- : 


•snoisinAnoo 


i i i 1 M i i : ! : i i : 1 ; i ! i ; i ; ; i i i i ; i • 


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1 h h l»M i i M I i M : i i i ; I i : ; : i i ; ; 


•asBasip s.mSug 


n M M M'^ N i H i ; I j 1 h M : i i M i : i 


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" M 1 M M M M ; i i" H 1 M M : : H- I M 1 


sasBasip iBaoi \vioj, 


,H,Hr-irH.-i j j :,-< jiN-H :eoTHia r^c^ : : : : ;e<i.-niMM . j — — 


•si[BaoTnind sjsiqiqj 


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i i ! h^ : j M M i-^ M ; N ; M 1 M i M^ ; - 


•spinisaox 


::: 1 ::•.: j :•:■ I ::::!::■.:;:: i : i .. : 


■aaA.ij lajJUDH 




•sjaAaj iBjadjanj 




•^Binvdji 


• »• : : 1 1 : 1 : 1 ! : I : : : : : : : : : : 1 : : : : • : : i 


•J.iAaj IBUBIBH 


1 M M I M M M H M M ; I H M ! ; i U ; M 


•XaauiasXa 


i :-^ 1 M^ : M i ; N N • M I ! M M i --^ ; M 


•sa^Basip iBajqwBfd 


• \ \ '■: \ ■'■' \ \ •': \ ■.'■ \ :: \ :•.■'::■'::■': \ \ 


1^ snqiora pja^oq.-) 


M 1 M M M H i M M M M 1 : M M M 1 M = 


siiiSniaara (Baids ojqrijaf, 


: M ; M M M ; i i M i M i : j : 1 I j : i 1 M i i 


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Biiaqiqdip puu dnojf) 


NkiMMiiiMMMiMMMiJiii - 


sasBasip o.nooj.^z ibjox 


io5!N(M-Hr-.MlTf< : IrH j— I(n3-H(M,-I j jN—l :-Hrt-OI I _:,-<COr-l iC 


ivaS. auo jaAO 
pnB siBaj£ aAi^ lapuii tbiox 


i- M i M i M ; h^ M M i ; M i i H H ; 


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i''=^ : : i 1 : : : i : i"^" i"^ : i'^'^ :'^~' :::::: « 


'doo'l J^d ai^i IBnuny 


11.06 

15 83 

18.18 

19.78 

7.86 

37.50 

1410 

13,80 

5.31 

5,15 

18.49 

16,88 

25.81 

36.72 

30.30 

19 24 

20.19 

37.26 

35.98 

1319 

8.84 

5.49 

8.30 

11.21 

24.97 

10.86 

6.0J 

1711 

23.00 

4 25 

9.20 

38,80 


■papnioxa sq^jiq 
-inis pan ajniTftuaij 
•sasnB.i TTB 'sqiB^p iBjox 


CM,H'*t^'MrHC0-«<r-lrHO-.O-.00mai(N— Id e<»*r-l rH,-<(N05F-IOJir>50r-l,-,QO 


0681 snauao 'noiiBiudoj 


2,079 
8,338 
2,640 
4,245 
3,052 

320 
2,533 
3,470 
2,257 
2,327 
3,241 
3,672 

465 
2,614 
1,980 
5,611 
1,171 

322 

667 
2,729 
1,437 
2,194 
1,444 
2,141 
4,320 
1,104 

394 
3,501 

2,826 
1,291 
2,474 


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Ada 

Ashtabula 

Bellefontaine ... 

Beii' vue 

Bourueville 

Ber. n.. 

Canal Dover 

<'artbage 

Clyde 

cJn.iCaut 

^'o^hocton 

CriaersvHle 

Cuyaho!,'a Falls 

Klyria 

Kairport 

Fairview 

Frankfort 

Franklin 

(Geneva 

(ileudale 

Hieksville 

Jackson 

laniestown 

Junction City.. 

Kent 

Lebanon 

Leetonia „. 

Liuwood 

Locklaud 



OHIO STATE BOARD OF HEALTH. 



239 



— 1 :;•::: :co :i-ie4 :::■-':::: ::'•*•::::: i"^ 


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ouorHNiN I : :->»<i-(rt :r-. : — .-(C^eo :•» •■<«t| ••-1 • jr-t^iM -g 


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15.39 

•27.14 

11.65 

8.54 

31.60 

9.97 

9.20 

4.34 

42.12 

8.16 

26.33 

5.04 

29.49 
13.85 
18.66 
13 71 
17.66 
15 46 
27.6T 
49.91 
12 37 
5.23 
11.52 
16.38 
8.66 
7.62 
23.19 
20.00 
■27.29 
24.75 


S 


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240 



ANNUAL UErORT 



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h N N h h N" M U i i 1 i U h h M i M 


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•sjiiSainapi 


nr.Mi-iUnhMiniri i i 


asBastp 5J89H 




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; r : : ; i ! i ! I i i i M M ; i i : ; : : i i N i i i 


■suoisitiAnoo 




siuqoauJa 




-aroasip s.iqSug 


irHihiMMnnhniiiinn; 


••Bixaidodv 


iHuniMiji-iiiii-ih"! i - 


•sasBasip iBOOi ibjox 




■siiunoiaind sisiqjqj 




•aaDUBo 




•sasBa 
-sip xBuotiniiisnoo ibiox 


r4 :o :^ I :eo : ,-1 ,-( i-i -^ t». -.^ : :«<n : j—ie^ .rn^ ciihcm : 


•qSnoo Saidooq^ 


i :- M M M i Mi- i N IN: i ii i =1 • i 


•jaAaj ptoqdix 




snTIisacx 


j ; M M M i 1 M I i : M M I M = M U i 1 M 


•jaAaj ^aiiBOg 


M 1 : M i 1 M h M U M M h h M ; : i M 


laAaj xBiadianj 


i 1- : : i M : ! ; M ! H M n M i M i i = 1 = 


•9a[SBan 




•sjaAaj xBuuxBUi 


ill: i — i i i i M i i ! i i U H M : I \ I 


•AiaiuasAQ 


i- i i ! I l-H 1 ; ;- ! : i ! i^ 1 ; i ; : I 1 : ..^^-. 


•SaSBaSip IBrUqjJBlQ 


: : : : : :::::■«::: 


i : i ;;;;;;;;; i-^ 


•snqaoca Bjaioqo 




\ W W h I \ i \ W \ 


sjataniuain iBuids-oaqajao 






•rammjjni Bjaxoqo 


.-( :iO : :co :'M : : : : :i-i-<^ ; 


::':':::-':: -N ::-< -H 


•Buaqiqdip puB dnojo 


:•::::•. : : ! : : : : 


i- i ; = M i 1 i i 1 i i 


sasBasip DjaoraAZ ibjox 


riijjc^to ;.»r-ccc I . jtHcxtot-iCT— ■— , :— :— . : :<» : :<Nio^eo-3< 


UBaA ano aaAO 
puB sjBaX SAij jflpnn ibjox 


• -^ : : : : :'=^ I :-'=^ ::::::.: -'-' : : :- : ^ : 




•iBaA aao aapati ibjox 


i i^ i ; i : ; : : : : ;^- •; i :::-::: = : i ; i'^ ; 


• : :::::::: r : : : ! : : • • • : 


'OOO'I J3d ai^-i iBtinny 


11.54 
45.09 
27.34 
18.18 
11.50 
18.95 
10 03 
27 69 
15 64 
5.31 
45.45 
20.67 
14.81 
35.94 
25 80 
27.54 
10 60 
; 10.60 

12.83 

37"26 
71.96 
17.5S 
34 41 
8.85 
27 24 
25.38 
80.55 
121.8.' 
21.13 
63.20 


papn[.;Xci aquiq 
-lUiH puB ainiBoiaij 
sas'nBD \\v sqiBap xb^ox 




0681 snsaao 'nonBindoj 


2,079 
1,331 
8.338 
2,640 
1,043 
2,533 
1,196 
3,467 
3,068 
2,257 

264 
2,327 
3,241 
3,672 

465 
2 614 
1,132 
1,131 
1980 
5,611 
1,171 

322 

667 
2,729 
1,046 
1,437 

881 
1,498 
4,320 

394 
3,501 

748 


a 
. 

^ ^ 


Ada 

AntwiTp 

Aiheus 

Kedlord 

Berea 

blam hosier ... 
Bowling Green.. 

Bryan , 

Can huge 

ClarkKtield 

Clyde 

Conneaut 

Co>hocton 

CriikMsville .... 
Cuyahoga Falls 

Delta 

Dovlestown 


Kimwood Place. 

Elyria 

Fairport 

Fairview 

Frankfort 

Frauklin 

Garrettsville 

Germantowu ... 

Greonwieh 

Hnhl.ard 

.IjickKon 

Juuction City... 

Kent 

Larue 



OHIO STATE BO.\RD OF HEALTH. 



24 E 



•M ::: —1 —1 :::::::::: c^ :::::: -H ::::::;::: : 


CJ 1 


: . i-i ,-1 j « : : . : : , I : : . .^ : : : 1 : : . CO -4 : : : CO : ^ i <-! . 1 c^ 


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U : r i 1 ; ; i M M h : h i ; N 1 : I M i" M ; h 


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M i r^ ii i i = M h M ^ Mi i- ii M i'-i ii : il- 


i i i- : ^-- i i- i : i j :- i i— i : : i ; | 1 | ; : : j ^ 


ih i h : i i- i i M i"" M i h : M M i M M : " 


i h M i i-* M M 1 I i : : i I j i-^ i - j j i i i j i ; i i " 


MMnNM i-h Mil MM: .H^M-:r 


|i M r M i i M ! M i- M : i i h ; - :- i- - 


1 H ; : i M = i : : 1 i r M i-^ h M ! : h r i I! 1 - 


i i^^Nco-o. i---^-^ : .^co--co-co _^ i ; : :<N ic^^c. eg 


M M M r i M M — Mi- " i- r i ^ 


r MM -M i \\:\[\\\:\\\ ; i i MMi i :^ 


M i i: M^ : ; ; ; i i r-- h^^-^ i 1 « - .^ 5 


Mhi-iii:-^: hi Hi i M; i i » 


i i : i i'^' ; :^ i-^ - M- i i ; 1 i-^ i 1 <^ i S3 


MMMhi h: :::::M i MM M h 


MMiMM Mi MiMM MMMi M i i 


M M M M M i I M M MM- Ml . ^ i i ^ 


M : 1 : M M - M^ ^ ii H :M M Ml i - 


iMMMi MM iMMMi MMi 1 


i ; M : i i : : i i i M- M ; ; : i M H 


iM M : : M M MM M M i^ i M 


MMMi:M :; MM: M ::HMi M - 


M M M M M M : : 1 ; i = : M f M M ii 1 = 


M i M" M M \ "^ ' \ ■ :'^ - i'* M M M i — : M 1 s 


M i- : M M i M : M M M i : M M M 1 M M : ^ 


1 i i- ^r- 1 CI :^,^ ;_^ l-ce.- co j ;— |^^^ i i : ;g 


; : 1 : - : - \- \\\ M " i i" : M -- ; = S 


i : I ;-« i : I \ ; i :-" :" :«-- • i : ;- ; : i-n ^ 




:— c5^K(NtC'-i.«'(N— .coeo-H-H — — w<j'Ki>:>:t^-<iCTi.K^-H.-oim-~eOTrr-i 


5 


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i M i M • = ^ it = ^IJlgf : ; M i |J M i M 

JJ^,r?l^.lifs=l!|ijy2ii:1f!itli|» 

nummimimuimmiimi 

SJii!s?Jliiillil.i;illlJ^iij|lilill 






16 



ST B. H. 



242 



ANNUAL REPORT 



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sesHa ; ;_irt05 .I-!.-! : :i-i i :::::: :i-i ;iH : : : : : : :c4 I 
-sip TBinoradOTSAap tbiox I • • = • = '.'•■.'■.•■'.'• • \ ■■•.':'•'. • 




Biuotnnauj : : : :^ i : : : : i j i i j i i i i : : i i i i i i i i j j i 




•.isijn9[d 1 i : i i^ !:::::::•:::::::::::: j j : j 




•siilSuiuaw 1 j • : i : : M"^ : I I ! • 1 : 1 ■ i i I i i"^ • : i • i •'^ : 




•asBDsip ?jBaH | 


:: i ::.;::::: i i :^rt : i : : :co^-, ::•:: = 








■sijiuo^uad pnB si-jiJiSBf) 


i :: .r^ ::: :^ i .:::.:::.:::.: i .: i :: i 








•snoisinAuoo 


i :: i^ ::::;::.;:.:• : : ; :-h i : : :^ . 








•sniqonoja 1 i j ; i M ; i j i = ; i ; ; : p : ; i : M :'' i i" i 




•88B8SIP s,^q8ua ! i i i^ i 1 : i ^ i : : :" : ; i ; 1 p ! 1 i ; ; ; " ; 




•Bixaidodv 1 i i i - i : i : ■ i ! • ■ i i ; : i i^ "":"": i 




•S39B39TP IBDOn^lOX !'"' • -"^ 1 i j-''-^'^- : :-;-c^-^'- | : -cim-n <n :-^ : 




•stiBnoraindsisiq.qd | j j i j-^ j -' i j j'^ j j i'-'^ ; j j i'^-' j !" j ; i 1=^'^ 




•jaouBO 


: : i i : : :^r-. : :-,- :.-,;.:..:..:::::! i-,* 




; : : : : • : : • : ■ : ■ r : • : : : : 




•sas89 1 ::::,h::?<-. eo-(:-i-iMi::;-H-c::!M:.::(N(N 
-atp T'snoT'tnaiasnoo itni>x 1 := = •': ? • • ■ • • :•.;:: 




qfluooautdouqtt ( : i j j ; : ; i^ ; j I ; i ; ; i = ; i ; = i ; i M ! 




jaA3J pioqd/Cx j io* ilji: : -m:;!::: r^ -* [ : \-- \ \ \ 




•Slllll^iuox 1 : : i i i ; I • : ••.! = ••: \ \ ■ : : : 




•iaAaj jailBJjj i ; i Mil: 1 • I 1 1 1 i ■ : : 1 ;-' : 




•jaA8J |BI dJanj | ; ; : • : j j ; ; i i :;•:::::: 




•SiisBaw 1 1 1 1 i 1 j 1 j • j ; \ \ \ \ \ \ 




saaA..} i^M^lBW 1 1 M i n ! • M : i 1 i=^ i f 




•A.8l..8.A(I 1 : : : : M 1 ill : 1 1 1 1 1 1 1 i ^ 1 M i^^ 




SdSBJSlp iBatqjjBia 1 i i i 1 : 1 ; I Mill M M M M : : 1 : 




•suqaoiu eidioqo 1 i : ; ; M : MM 1 M " i M ^ M 1 : 




•sHiSuiaatniBuids-ojqaia.) j : : M 1 M 1 MM M MM 1— : - : 




■uiniuBjuiBiaioq ( | : r^ | jl 1 11 ■ 1 1 - 1 ; :-- Mi --11 




•Bti q.qdippuBdnoaO | \ \^ \ , M : : : . M. • i 1 ^ i M - i ; = ! 




■sasBasip ojioniiz IBJO 1, i"^ : M'"' j M M'^ :"^ 1 MM- M"'^ :^-?Ja>c^-H 




jBaXauoa^Ao 1 .::„:: : ; i i i ■ : j : ; ; j : : :?< . : ,^ : 
pnBsiwaiaAtj japan imoT 1 • ■ ■ . . . . 




•jBaXano japun iBjoi | : M"" M ' • M M • '^ J '^"' 1 • 1 •^'^ ■'^ 




"OOO'l -lad aiBi iBnnnv 


recce tor-*«cc^-.cTJio«3aocc — — in-*ji-^cojo^;t^cc.:;r^T5iir:'^cooo 




•papntoxasquiq 
-niis puB ajniBcaaij 
•sisn^o irw 'smwap (hioi 




CO— 1 — io.-tc<coMe<iiM-x>-iTr-i'N-*s^r-ir-(^Trou's':^ioco-3>c<:-9'Oco 




•0681 snsuao 'noUBindod 






s 

> 

OQ 


a 

< 


Anna 

Ashley 

Ashtnbula 

Blake's MUIb.... 
Bloomingburg. 

Bryan 

Carthage 

Clifton.Ham.Ci 

Clyde 

Cjshocton.. . 
Cridersville .. 
Cuyahoga Fall 

Eimwood Plftct 

Elyrin 

Fairport Harb' 

Frankfort 

Garrettsville .. 
Germantown .. 

Hartwell 

Jackson 

Kent 

Larue 

Lebanon 

Leetonia 

Lockland 

Logan 

London 


:' u 

2 9 



OHIO STATE BOARD OF HEALTH. 



243 



: I : :"' 


1 i i'^'^ i : :'^ i i : M i 1 : M M 




05 


1 


M i ;i H i i-^ M H M N i M ; i i M Ml- 


h M M i M i M i h 1 h M M h h : M- 


i i M h ii M M i 1-^" N M i M M i M h 


MMiiMhiiMMMMih MMh 


-MMi M NMUMMMMMMh 


hMiiii 1- i iMMMihih 


-iiiMMMl ir iMMM Mr H- 


1 j 1 1 i i M : i M M M i : i M i ; i i i|" 


M ! M h ! M ! i i ! : i M M I I i i-^-^ i 1 h 


M i i" ^ ! M i i P i i : M i : ; ; M : h-^ h 


i = i i : 


; i ^ I '^ i ; = i'" i i ; i : :'" : : 


1 * 




(Nrt ri : ; I : . . .cmco |<NrH,-. i i : i I ^r-^^^ 


Ir. 




1 "^ 




j- ! i i i ; M-^ i i ^ : M M i i i •- ; 1-^ ;|2 


Hill '"'^ 1 h M -^ i -^-^ M" i|55 


MiU M MM i i M 


CM 


M M i« . M ! M i M • - • ^ 


^ 


: : : : : 










- 






■ 




::::::::;::::::::::::; 


i 


^ :• ; i ; 




CO 


i 1 !- i 


! M I M M M ! M M M M M : 


"5> 






- 






• 




: i^:;::::::'^::::;:::: 


- 


- M- i 


;—,••:;;"•: CM I :: o* :::::: ,-1 : 


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':':■»:': 


'::'.::':;::: M ■; I ■:;:::':: 1 • 


t^ 


c. :cc ;c. |w :co i- : , :^» :~co-.^ ^ p . ,^ : | g 


-MMi-Mi -MM-i:iM: Ml :!2 


- M ; ^ -- : i : i=^ M*" M :"-" ^ : ; : i • 1 s 


4661 
13.65 
9.97 
33.74 

'868 
19.89 
8.16 
10.95 
30,6 

21' 'sV 

8.00 
5 48 
7 73 
20.23 
24,28 
11.52 
16 3H 
9 37 
9 43 
8.66 
7 6.' 
17.39 
10 Oo 
22 85 
15 59 
8.25 




■^C^C^CO ;C^(N,^^(0 ; CC CO C^ :^ CC TT r^ C* CC ^ f-1 rl CO F-< Cn» -^ T-< 


to 


cc t- = to - -.o ?:ci^ =-. 1^ X -T = r~ o I- t^ -w to Ti. - (X I- «o o S 1- ■«* -^ 
3,c-_->j> ip>ci>?j Tf _ cc t>toic -.— r-ai o -r X M CO icooj = oo_ i — 


McComb 

McConnelsville. 
Mingo Junrtion 
Mount Healty .. 
Munay City 


New Hrt-men 

New Lexington 

New London 

New Richmond 
NewStraitsville 
North Amherst. 

Norwood 

Obarlin 

Reading 

8t Bernard 

Shelby 

8. ("harlf ston ... 
Tipp cinoeCity 

Uhrich^ville 

Uuion i.ity 

Versailles 

Wadsworth .... 
Wellington ... 
West Liberty ... 

Westwo )d 

Wilmington . ... 

Wvnminf 





c 

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244 



ANNUAL REPORT 



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•smaiq-niis puB ajiuBmajj 


: 1! P i 1 i i'^ 1 M'^ :'^ i : : i'' U : I 1 M ! : i : 


•30U9IOIA IBJOX 




•sasBa 
-sip xBinatndoTSAap \vioj. 


M M H M M M M M M : h M h i M i h i 


•Binoninanj 


; :- M M i M i i M i M M i M h M M h M 


• Asunajj 




■stit8atn9iij 


i M i i" i M i ; H" ; M i : r M 1 I i M i ; 


•asBastp iaB3H 


M ; i i i h- h" h i i H -^ i :- : h ^ i 


■sninojuad puB shihsbo 


h . M i : i i :- N- i i- i M M M 1 : N r M 


•saoTsitiAuoo 


: ! i i i i i M i 1 ! i^ i i i ; i : i-^-^ i i-" i ! i • i 


•siiiqouoja 


M i i M M 1 ii M = i i i M i i i M i : M i ri 


•es-easip s.iqaug 


'^ 1 h M M M M i'^ M M i h : N i r M M 1 


•■Bixaidodv 


-- j-^ : h-^ h ; ; M i M ; M r ; i i" M ii i 


•B9SB9SIP IBOOI IBJOX 


C^rHr-lrH . -H : ,-H ,-1 IrHIM : tO : : ,-H -H ri t-H CO M ,-1 -H ^ C< --( : CM CO i-l I 


•anBuotajTid sisiqiqd 


i i-— i ; i i- = I i ; i i i i i i--^ : r r h ^ : 


•jaouBo 


-^ ! M M M M M i M h j h r M i-^ i i-^ i 


-sip TBnouniiisnoo tbiox 


^ ;-<N- 1 1 1 ^^1 i 1 i 1 . p : jc.^^ ;,-, |c. 1 I ^« ; 


•qSnoo "OidooqM 


M M = h i 1 ;- ; M M 1 M i i M : i i : i 1 


aaAaj pioqdi:^ 


1 ; :^,H ::::-. jrH- : : : : i : ji^ :- : : - : : 


•siiltisnox 


: M n H M = H M i M h M 1 : i 1 M • ! 


•J9A9J laiJBOS 


: ; M i : i • 1 1 f i i ! ; i i i i 1 i i ! 1 i i M i i 


•18A3J xBjadjanj 




•S-^ISB^K 




•SJSAa} XBUBIKJIJ 


M M M M M : ; i ; = H ■ • i i"^ i h M h i 


•.^lajnasiCn 


i ! ! ! : ; ; ! M ; 1 1 ; = M i ! ! !"^ i ; ! : ; i \ 


•sasBasip iBaoqjJBia 


■ i i 1 i i- ; i i i i i i ; ; = : i : M-^ : ; ! ; 1 • i 


■snqjoni Biaxoq'i 


H ; M M ; M : h = : i ; M i N ! M M : i 


8iai3niu8ai I'Buids-ojqgjao 




•mmnBjni Biapiqa 


i 1 1 i i i : i I-' i i i i i i : i M H ; = i i i ill 


■Buaqaqdip pn-B dnoif) 


- ! i ; i i ; i i^ 1 n i : i i M i i i i M i i- ! i- 


•S39B*8ip oiioin^z IBJOX 


,-1 I jrirH :— :r-iio jrtc^ : :— : . : :<N'«"eo . :n .r-t , :.^ 


puB fiiv^S. 8Aq japnn ttiox 


: i M r- i M M : : M M = =" = ; h i ; Mi 


ub3jI auo japnti ibjox 


1 i ; M i i : i i i i ! I ! h M i h^ i-^-- i = : i 


OOO'T J'^d aiBJ [Bnauv 


co'^rcn— .OCM^icoiq-js x:t~_ ^jcoT.JccoS'rMaincocM-^GCrrTCOJCi'ocTjiM 
e^ -H ii^ ..H ^ "•—.—( ^.j -^ ^H CO -—.»-,.—, ^co.o — ,— j>i ^Hcr^ — 


papniox.) sqiaiq 
-nns puB aimBinaij 
•sasnBD ((B 'saiBap imox 


iOr-.IM>0(Mr-(r-lrtIMtOrtMrHOrHrHrtrHr-l.-,OOOi«.-l'N-<J,CO— iC<COiO-H 


'0681 snsuao 'uoi^Btndoj 


2,079 

6 8 

2,64 1 

1,196 

2.2 -1 
1,299 

300 
1575 
1,227 
3,672 

465 
2614 
1816 
1,980 
1,171 

779 

667 
1,046 
1,437 
1.5U7 

4.3 

3 501 
948 

3.150 
1,291 
3.1 9 
1.771 
2,408 
1,470 

4 456 
2,782 


<B 
DO 

as 

> 


Ada 

Ashley 

Blanchesier ... 

Carthage 

Chicago 

C arksfleld 

Clifton, Ham.Co. 

Clyde 

Cohhocton 

Cridersville .... 
C uyah<ga Falls. 
E SI Palestine... 
Elmwood Place 
FHirport Harb'r 

Felicity 

Frankfort 

GarreJtsville 

Hartwell 

.Jackson 

Kent 

L-irue 

Lebanon 

Linwood 

l.ogan 

Mc lonnelsville 
>iineo JunctiO' 
New Lexington 
New London ... 
N Philadelphia 
N. Straitsviile... 



OHIO STATE BOARD OF HEALTH. 



245 



:iHi-i<N :c4i-i 



:r-(^i-( :c^ 



>OC^C^1O'M«'C£><Ni-«i0 00 0'-aDr^OCSO 



,_i_i .-«f-.C^ — — ■r^ — lO — tNCC'M'M ^- |-^ 



wr-cOiCt-H-^ioc^t^ooc^c^co'^iocac^c^ 



CO o CO t^.-^c3 — "— c^ Ci^Tp TT CJ lO O.OJ o ys 

.-i-^Tf Trr-'c^COC^COr-" ^-i r-T i-T c4" rH CO i-T 




246 



ANNUAL REPORT 



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i i h 1 j 1 1 : i 1 i r h h i-^^ 










sesBa 
-sip iBanaradojaAap iBioy, 


: : I rH : (N : : rH : : : I : : : : : : : : 1 ; 1 ; : I ; I : : 1 


•Binoinnanj 


M M 1 il i li-^ I i i-^-" h 1 1 M i H ! h M i-^ 


•Xaiinaij 






•siijSninapn 


li i i h-^ 1 i :^ i i : ! i h i : h M M M" M i 


asBasip 1IB8H 


■^ M M M h'' ir r M*"" i'^'^'-'^ :::-:;;: 


•sijmoiudd puB siiu^sBf) 


i I : j^ j i i i i 1 1 M i i 1 1 i : i i : 1 i i 1 i" M : 


snoisinAnoo 


: 1 • 1 M i : : : : i- 1 i ; i : ; ; : i 1 : : i i ; ; 1 i i 


•siiiqanoia 








•3SB8stp s.iqSijg 


; i-' ! ; 1 i i M !'" i i I i i I i i i 1 i i i i i i i i M 


inxaidodv 


M i h 1 :'' i i 1 1-^ i M M i i M U i h'^ M i i 


•sosBasip iBOOi it?:^ox 


r-l :-- ji-tiHr-lrt jrHNiHTJl J Cil O) j M i-H ; iH rH ■-1 tJ i-( :rtrHO ; :»H 


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27.46 
15.?9 
58.32 

9.99 
30.10 
15.61 
10.63 
88.23 

9.23 
4000 
14.60 

9.78 
14 81 

6 53 
13.72 
2fi.42 
20.50 
13.19 
16 68 
15.92 

6.56 
17.15 
12.66 

6.84 
21.22 
55.55 

3.85 
22 94 
22 23 
19 92 

4.34 
16.32 


•papnpxa sqaitq 
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e<rHMc<c<5Tjio>(MrHric<i>-'->j<(Ncc-<a<e^eoe<iNe»iOi-i(Nmcirt5om-»>H<N 


•0681 snsnao 'nonBindoj 


874 

780 

628 
2,640 
1,196 
3. Of 8 
2257 

272 
1,299 

300 
1,575 
1,227 
3,241 
3.672 
2,614 
1.816 
1,171 
2,729 
1,437 
1,607 
4.320 
3,601 

948 
3,050 
2,826 

432 
3,119 
3,313 

2,408 
2.764 
1,470 




(H CO 

II 


Aberdeen 

Archbold 

Ashley 

Athens 

Blanch ester 

Bryan 

Carthflge 

Catawlja 

ChicHBo 


Ciarksfield 

Clifton, Hbhi.Co 

Clyde 

Conneaut 

(Joshocton 

East Palestine... 
Fairport Harb'r 

Franklin 

Gernianiown 

Hartwell 


Kent 

Larue 

Lebanon 

Leetonia 

Lexington 

Logan 


Lorain 

Mingo Junction 

Napoleon 

New Lexington 



OHIO STATE BOARD OF HEALTH. 



247 





M M J h M = ! i h 




|« 


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5.27 
21.90 
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«62 
14 5 
69,2 < 

6.99 
17 56 

7.73 
1 11.06 
2941 
36.42 
34.56 
43.63 
40.95 

9.43 
45.72 
17.39 
30 00 
34 26 
11.71 




i-,?J-<J,MNiOrtCOC^MXtOCO — lOfHtOMMCOM 


in 


2,278 
1,096 
2,379 
2,782 
1.648 

1,717 
2 049 
3,103 
2,169 
3,266 
1077 
1,041 
2:5 
1,465 
1,293 
1,574 
2,069 
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1050 
3,079 


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WelliiiKton 

West Liberty.... 

Westwood 

Wilmington 


"5 






00 ^ 



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S a 



ANNUAL REPORT 



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:::::::•':::::::■:::::::: 


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::jc4::j>-ir-i:::j:i-i;::?4i::i::iM:|i-<iHT><: 


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11.54 
4.54 
16 09 
53.25 
7.86 
4013 
18.80 
19.55 
18.47 
10.32 
14.81 
16.34 
34 28 
25.80 
3213 
13.22 
ti.66 
17.11 
20.49 
35.98 
27.22 
19.29 
25.00 
20.56 

i6.98 
27.88 
2910 
11.54 
1810 
19.74 


■papiqaxa sq^jiq 
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c^— iot^N'^<Mm(M(NTi<,n--'i-it-oii-iaoc-4(Nc^ir-ioito :T)<eo«DMioco : 
CO : : 


'0681 9n9nao'noiiBindoj 


2,079 

2,640 

4,473 

8,338 

3,052 

1,196 

638 

3,068 

1,299 

2,327 

3,241 

3,672 

350 

465 

2,614 

1,816 

1,980 

5,611 

1,171 

t67 

881 

622 

4,320 

3.501 

3,0.'>0 

2,826 

l,v9l 

2,474 

3,119 

3,X13 

4,863 

763 


1"^ 


Ada 

Athens 

Ashtabula 

BcUevue _ 

Bianchester 

Bloomingburg.. 

Bryan 

Chicugo 

Clyde 

Couneaut 

Coshocton 

Copley 

Cridersville 
Cuyahoga Falls 
Enst falestin. .. 

Elyria 

Fairport Harb'r 
Frankfort 

Hamden 

Jacksou 

Kent 


Lebanon 

Leetonia 

Linwood 

Lockland 

Logan 


i 3 
o >« 



OHIO STATE BOARD OF HEALTH. 



249 



I : !" : 1 l'^'-' •'^ I • ; i i 1 : : i 1 I • : : : : 


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loo 


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1 


hi! : i i ; i : i i ; = H ; i i ! h i i |2 


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. MMMi-i-i-ii: MfiM :-- ih 


Mi- MMii— Mi :Mir -Ih 


iH l-HCOrH ir-ieO M T « (N « ,-1 r- « ,-. r-l rH <N j CO rH IN (N It^ 


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- 


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; : i ; : i ; i i : i ; : i : : i- i ; ; { ; : ; : : 


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IN 


: ..•■•; :.:::::: :••■;::: 
:-^ i i = : 1 • :« : i ; : = : : i i : : : : i ; i : 


m 


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12.19 
9.77 
4.71 
10.53 
24 53 
5.27 
2189 
10.77 
10.09 
34.50 
43 68 
13.33 
10.97 
1A62 
10.00 
27 33 
11.60 
1107 
4.95 
23.05 
20.61 
16.38 
10.82 
17.39 
lO.OJ 
34.28 
15.59 




eoc<»'H'*rcOf-Hc^TP(NooC'ic-^iO'X)ioco(>ioJc^^-to»iMco«-HCC'**' 


en 

IN 


2,952 
2,408 
2,518 
4,558 
1,470 
2,278 
1,196 
4,4.% 
2,379 
2,782 
1,648 
4,500 
4,376 
4,7.55 

600 
2,049 
3,103 
2169 
4 850 
1,041 

582 
1,465 
1,293 
2,069 
1,200 
1,050 
3,079 




Miamisburg 

Mingo Junction 

Murray City 

Nelsonville ... 
New Lexington 

New Lisbon 

New London 

N. Philadelphia 
New Richmond. 
New Straitsville 
North Amherst. 

Norwood.. 

Oberlin 

Painesville 

Pleasant Ridge 

Port Clinton 

Reading 

Riverside 

Sidney 

S. Charleston 

Summerfleld 

TippecanoeCity 

Union Citv 

Wellington 

West Liberty 

Westwood 

Wilmington 


1 

o 

H 



H -3 



Summary of JMortality peports.. 



The total number of deaths reported from all causes — excluding 
premature and still-births — by the towns represented in the foregoing 
tables was 23,993. The average population of the cities and towns rep- 
resented was 1,372,133, which is equal to an -annual death rate of 17.48 
per thousand living population represented. 

The deaths in 1,364,945 living population in 1893 were 23,794, equal 
to an annual death rate of 17.43 per thousand; while in 1892 (November, 
1891, to November, 1892,) the total number of deaths reported in 1,265,070 
population was 22.957, equal to a mortality rate of 18.14 per thousand. 

The number of deaths reported each month was as follows: 



January , 



1,886 I July 2,547 



February 1,861 

March 2,027 

April 1,82-5 

May 1,905 

June 1,982 



August 2,311 

September 1,846 

October 1,916 

November 1,920 

December 1,967 



The greatest number of deaths (2,547) was reported in July; the 
least number (1,825) in April. 



DEATHS OF CHILDREN UNDER FIVE YEARS OF AGE. 

The number of deaths reported of children under five years of age 
(premature and still-born excluded), was 7,774, which is equal to 32 
percent, of the deaths from all causes, and a death rate of 6.38 per thousand 
population represented. The death rate of children under five the pre- 
ceding year was 5.42 per thousand population represented. 

The deaths by months, of children under five, were as follows : 



January 527 

February 500 

March 531 

April 529 

May 601 

June 680 



July 1,010 

August 982 

September 674 

October 620 

November 596 

December 524 



The greatest number of deaths reported in children under five (1,010) 
was in July ; the least number (500) was in February. 



OHIO STATE BOARD OF HEALTH. 



251 



ZYMOTIC DISEASES. 



The total number of deaths reported from zymotic diseases was 
5,447, which is equal to 23 per cent, of the deaths reported from all 
causes, and an annual rate of 3.97 per thousand of the population rep- 
resented. 

The number of deaths reported the preceding year from zymotic 
diseases was 5,240, equal to a death rate of 3.84 per thousand population 
represented. 

The number of deaths reported from zymotic diseases each month 
was as follows: 



January 368 

February 321 

March 320 

April 269 

May 294 

June 388 



July 842 

August 771 

September 545 

October 493 

November 451 

December , 385 



The month having the greatest number reported (842) was July ; the 
one having the least (269) was April. 

CROUP AND DIPHTHERIA. 

The total number of deaths reported from croup and diphtheria was 
981, which is equal to 4.09 per cent, of the deaths reported from all 
causes, and a death rate of .72 per thousand of the population repre- 
sented. 

The number of deaths reported the preceding year from these causes 
was 1,129, equal to a mortality rate of .82 per thousand of the population 
represented. 

The number of deaths reported each month from croup and diph- 
theria was as follows : 



January... 101 

February 83 

March 68 

April 69 

May 64 

June 41 



July 48 

August 60 

September 68 

October 108 

November 155 

December 116 



The month having the greatest number reported (155) was November 
the one having the least number (41) was June. 



252 



ANNUAL REPORT 



CHOLERA INFANTUM, CHOLERA MORBUS AND DIARRHCEA. 

The total number of deaths reported from cholera infantum, cholera 
morbus and diarrhoea was 1,527, which is equal to 6.36 per cent, of the 
deaths reported from all causes, and a mortality rate of 1.11 per thou- 
sand population represented. 

The number of deaths reported the preceding year from these causes 
was 1,053, which is equal to a mortality rate of .77 per thousand of the 
population represented. 

The deaths, as reported by months, were as follows: 



January 14 

February 14 

March 22 

April 20 

May 33 

June 101 



July 545 

August 429 

September.. 202 

October 87 

November 34 

December 26 



The month having the greatest number reported (545) was July; the 
months having the least (14) were January and February. 



MEASLES, SCARLET FEVER AND WHOOPING COUGH. 

The total number of deaths reported from measles, scarlet fever and 
whooping cough was 965, which is equal to 4.02 per cent, of the total 
number of deaths reported from all causes, and a mortality rate of .7 per 
thousand of the population represented. 

The total number of deaths reported from these diseases during the 
preceding year was 425, equal to a mortality rate of .31 per thousand 
population represented. 

The deaths, as reported by months, were as follows : 



January 53 

February 52 

March 67 

April 56 

May 89 

June 107 



July 95 

August 91 

September 79 

October 78 

November 122 

December 76 



The month in which the greatest number of deaths was reported (122) 
was November; the least number (52j was reported in February. 



TYPHOID FEVER. 



The total number of deaths reported from typhoid fever was 709, 
which is equal to 2.96 per cent, of the total number reported from all 
causes, and a mortality rate of .51 per thousand population represented. 



OHIO STATE BOARD OF HEALTH. 



253 



The number of deaths reported from this cause the preceding year 
was 718, equal to a mortality rate of .51 per thousand living population 
represented. 

The number of deaths from typhoid fever, as reported by months, 
was as follows : 



January 55 

February 

March . 

April 

May 

June 



40 
48 
25 
17 
32 



July 45 

August 92 

Bt^ptember 98 

October 109 

Noven ber 67 

December 81 



The greatest number of deaths (109) was reported in October; least 
number (17) in May. 



CONSTITUTIONAL DISEASES. 



The total number of deaths reported irom constitutional diseases 
was 4,185, which is equal to 17.44 per cent, of the deaths reported from all 
causes, and a mortality rate ol 3 05 per thousand population represented. 

The number of deaths reported from constitutional diseases the pre- 
ceding year was 4,009, equal to a mortality rate of 2.93 per thousand 
population rrpresented. 

The number of deaths, as reported by months, was as follows: 



January 344 

February 322 

March 405 

April 337 

May 350 

June 356 



July 391 

August 377 

September 313 

October 326 

November 326 

December 338 



The greatest number of deaths (405) was reported in March ; the 
least number (313) was reported in September. 



CANCER 

The total number of deaths reported from cancer was 783, which is 
equal to 3 26 per cent, of the deaths reported from all causes, and a mor- 
tality rate of .57 per thousand population represented. 

The number of deaths reported from this cause the preceding year 
was 694, equal to a mortality rate of .5 per thousand population repre- 
sented. 



2<^4- 



ANNUAL REPORT 



The deaths, as reported by months, were as follows : 



January 67 

February 69 

March 75 

April 49 

May 72 

June 59 



July 84 

August , 65 

September 59 

October 67 

November. 66 

December 56 



The month having the greatest number reported (84) was July; the 
month having the least (49) was April. 

CONSUMPTION. 

The total number of deaths reported from consumption was 2,712, 
which is equal to 11.33 per cent, of ths deaths reported from all causes, 
and a mortality rate of 1.97 per thousand population represented. 

The number of deaths reported from this cause the preceding year 
was 2,648, tqual to a mortality rate of 1.93 per thousand population rep- 
resented. 

The number of deaths, as reported each month, was as follows : 



January 240 

February 212 

March.. 282 

April 246 

May 228 

June 235 



July .. 232 

August 251 

September 185 

October 190 

November 197 

December 214 



The greatest number of deaths was reporttd in March (282), the 
least number (185) in September. 



LOCAL DISEASES. 



The total number of deaths reported 'rem local diseases was 10,698, 
which is equal to 44.50 per cent, ot the deaths reported from all causes, 
and a mortality rate of 7.79 per thousand populition represented. 

The number of deaths reported trom local diseases the preceding year 
was 10,861, equal to a mortality rate ol 7.9 per thousand population 
represented. 



OHIO STATE BOARD OF HEALTH. 

The deaths, reported by months, were as follows : 



255 



January 904 

February 957 

March 1,030 

April 953 

May 992 

June 880 



July 905 

August 812 

September 683 

October 766 

November,.. 841 

December 975 



The month having the greatest number of deaths reported (1,030) was 
March ; the one having the least number (683) was September. 

BRONCHITIS, PLEURISY AND PNEUMONIA. 

The total number of deaths reported from bronchitis, pleurisy and 
pneumonia was 2,828, which is equal to 11.79 per cent, of the deaths re- 
ported from all causes, and a mortality rate of 2.06 per thousand of the 
population represented. 

In the preceding year there were 2,960 deaths reported from these 
causes, equal to a mortality rate of 2 16 per thousand population repre- 
sented. 

The deaths, as reported by months, were as follows : 



January 308 

February 330 

March 315 

April 304 

May 288 

June 243 



July 169 

August 117 

September 97 

October 153 

November 220 

December 284 



The month in which the greatest number of deaths was reported was 
February (330) ; the least number (97) was reported in September. 



CONVULSIONS AND MENINGITIS. 

The total number of deaths reported from convulsions and menin- 
gitis was 1,554, which is equal to 6.48 per cent, of the deaths reported from 
all causes, and a mortality rate of 1.13 per thousand population repre- 
sented. 

The number of deaths reported from these diseases the preceding 
year was 1,676, equal to a mortality rate of .22 per thousand population 
represented. 



256 



ANNUAL REPORT 



The deaths, as reported by months, were as follows : 



January 119 

February 135 

March 187 

April 123 

May 141 

June 153 



July 128 

AuauRt 104 

September 95 

October 103 

November 136 

December 130 



The greatest number of deaths was reported in March (187); the 
least number (95) in September. 



DEVELOPMENTAL DISEASES. 



The total number of deaths from developmentil diseases reported 
(excluding premature and still-births) was 1,8-51, which is eqaal to 7 75 
per cent, of the deaths reported frond all cause?, and a mortality rate of 
1.35 per thousand population represented. Daring the preceding year 
there were 2,093 deaths reported from developmental diseases, equal to 
a mortality rate of 1.53 per thousand population represented. 

The deaths, as reported by months, were as follows : 



January 165 

February 152 

March 151 

April 152 

May 139 

June 176 



July 173 

August 141 

September 130 

Octobtr 152 

November 154 

D. cember 166 



The greatest number of deaths (176) was reported in Juoe; the least 
number (130) in September. 



PREMATURE AND STILL-BIRTHS. 

The total number of premature and still-births rep 'rted was 1.994, 
which is equal to 8.31 per cent of the deaths reported from all causes, 
and a rate of 1.45 per thousand pipuUtion represented. 

During the preceding year there were 2.011 premature and still-births 
reported, equal to a rate of 1 47 per thousand p puliti.)n re,.resn'ed. 



OHIO STATE BOARD OF HEALTH. 



257 



The premature and still-births, as reported by months, were as fol- 
lows: 



January 160 

February 165 

March 212 

April 158 

May 214 

June 151 



July 158 

August 159 

September 145 

October 143 

November 159 

December 170 



The greatest number (170) was reported in December; the least num- 
ber (143) was in October. 



VIOLENCE. 



The total number of deaths reported from violence was 1,204, which 
is equal to 5.23 per cent, of the deaths reported from all causes, and a 
mortality rate of .88 per thousand population represented. 

During the preceding year there were 1,233 deaths reported from 
violence, equal to a mortality rate of .9 per thousand population repre- 
sented. 

The deaths, as reported by months, were as follows : 



January 73 July 



February 83 

March 69 

April 83 

May 101 

June 128 



142 

August 131 

September 109 

October 99 

November 100 

December , 84 



The greatest number of deaths was reported in July (142) ; the least 
number in (69) March. 



17 



ST. B. H. 



APPENDIX I. 



Proceedings of a Meeting 



of the 



State Board of Health 



Local Boards of Health of Ohio, 



Columbus, Ohio, January 24 and 25, 1895. 



RKPORT OK THE PROCEEDINQS 

— of the Meeting of — 

State and Local Boards of Health 

— held in the — 
Y. M. C. A. Building, Columbus, 0., Jan. 24 and 25, 1895. 



FIRST SESSION. 



Thursday, 10:30 a. m., January 24, 1895. 

'1 he meeting was called to order by Dr. Byron Stanton, President of 
the State Board of Health, who, on taking the chair, spoke as follows : 

Gentlemen: It is not expected that I shall address you at length in 
opening the work of this meeting. The object of our coming together is, 
doubtless, known to all of you. We have met as the representatives of 
the various boards of health of the State, for the purpose of conference 
upon matters relating to sanitary science, to increase our knowledge of 
the fundamental principles of health, to stir a little leaven into the pub- 
lic mind and give an increased Impetus to all sanitary activities, to bring 
into harmonious action our various health organizations, to the end that 
sanitary laws and regulations may be better enforced. 

It is a matter of great gratification that our meeting is so well attended 
and on behalf of the State Board of Health I thank you for this manifes- 
tation of your interest. 

Our program shows some departure from the usual custom, and it is 
believed that by this means we may assist in clearing up some of the 
problems that loom up before those engaged in our line of work and give 
more practical range to the discussions, and thus meet more particularly 
the difficulties that beset the way of the practical sanitarian. 

We are anxious to have those who have come here from the diflferent 
parts of the State discuss the topics with which they are familiar, and I 



262 ANNUAL REPORT 

am confident that valuable knowledge will come from a free exchange of 
thought. Work in this and other directions that may suggest them- 
selves will well repay us for the time and money expended for this 
meeting. 

I now call upon Dr. Kahle, who has had experience as a health oflEicer, 
to tell us something about the duties of that ofiice. 

WHAT ARE THE DUTIES OF A HEALTH OFFICER? 

By Dr R. D. Kahle, Membei State Board of Health, Lima. 

Mr. President and Gentlemen: On the efficiency of the health officer much 
depends. If he is a man of ability and a good sanitarian, he can do much to advance 
the cause of hygiene and hold in check those diseases that decimate our State. 

The community in which he lives naturally looks to him to ferret out contagious 
and infectious diseases, and to use all means within his power to stamp them out of 
existence, and to use his office to make the place healthy, pleasant and happy. 

It is not likely that any great epidemic will again visit our country, such as small- 
pox, cholera, typhus fever, or the plague, although cases may occur in different localities. 
We must not forget that scientific, rational, intelligent hygiene is a thing of the present 
generation ; yet we have made rapid progress in that time, and few subjects are more 
popular or more calculated to advance the interest of the State, or to yield larger returns 
both as to material wealth and happiness for the labor and money spent. The measures 
looking to the preventioft of disease by the use of scientific methods are modern. The 
maxims of Hippocrates, the ceremonial of the Hebrew law as to bathing, and the estab- 
lishment of quarantine are almost the only exceptions. For the most part suffering has 
been regarded as an infliction of the gods, or a dispeneation of Divine Providence. 

The law passed March 14, 1893, creating a board of health in each township of the 
State, as well as each city and village, is certainly a wise provision ; as working in 
harmony with the State Board, it gives concert of action that bears fruit in our State. 
It is mandatory for the city and village boards to appoint a health officer, and the town- 
ship boards may, and I believe should, appoint one. The law only in part defines the 
duty of the health officer, but gives the board of health power to do so. He is powerless 
without the action and co operation of his board, as he is an officer of said board, and 
must execute the order and rules passed upon by them. He has no authority within 
himself, but his jurisdiction is given him by the board of health of which he is the 
executive. 

Where possible, the health officer should be a physician. The perfecting of sanitary 
science depends largely upon the physician, who has done more than all others in the 
cause of hygiene ; and to him we must look for advancement in the future. 

It is unnecessary to call your attention to the progress sanitary science has made, 
more than to mention that man's lease of life has been lengthened, and his surroundings 
made more healthful and pleasant, as well as more secure. When the periods of infancy 
and youth are made as secure and free from disease as adolescence, when contagious 
diseases are held in check, such as small-pox, or obliterated completely, then we will 
have reached a triumphal period in our history. There has been inaugurated interna- 
tional hygiene, a system of sanitary administration which in my judgment is destined 
to control, /uppress, and finally exterminate contagious and infectious diseases. 

The people should be alive to the fact that a well paid health officer, supported by 
well framed and comprehensive laws, is as much of a necessity to the common weal as a 
well paid mayor, police, sheriff" or township clerk. Where it is rightly understood, 
hygiene is to-day one of the most popular of subjects. The local board of health naturally 
looks to the health officer to keep it informed on sanitary matters, and through him 



OHIO STATE BOARD OF HEALTH. 263 

most all communications reach the board. The members of the board are not selected 
on account of their sanitary knowledge, but are frequently men of sound judgment, who 
are anxious to do all in their power for the best interest of the community, andean 
readily discern what is meritorious, and what is not, when rightly presented to them; 
and very properly they rely on their health officer for advice and direction. 

Not the least important duty of the health officer is his dealings with contagious 
diseases. It is very essential that small-pox, diphtheria, scarlet fever, measles and 
kindred diseases, be promptly reported to the health officers, who should, without delay, 
have the house placarded and properly quarantined, and use every available means 
known to prevent the spread of these diseases. Quarantine should be so regulated as to 
give the greatest safety with the least interference possible with the public. There are 
times when a house to house inspection should be made, for all contagious diseases are 
not reported by those in attendance, they either failing or refusing to report the same. 
There are places where the number of deaths from a contagious disease is greater than 
the number of cises reported. 

The principal of schools, or school teacher, should be notified, and children from 
families where contagious diseases exist should be prohibited from attending school as 
long as there is danger of contagion. In case of death, public funerals should be abso- 
lutely prohibited. The health officer should either see personally, or through a com- 
petent sanitary policeman, that the room in which an infectious disease has been is 
properly and thoroughly disinfected. Those exposed to smal'-pox, cholera, typhus or 
yellow fever, should be kept under surveillance until all danger is passed. Railway 
cars, steamboats and other conveyances should be disinfected after carrying persons 
afflicted with any of these diseases. 

A burial permit should be required in all cases, and an accurate record kept of all 
deaths, with the cause and duration of the illness. Death reports are of but little 
value unless they are full, accurate and complete. A partial report of the deaths is 
misleading and cannot be relied upon. 

The way to obtain data on these subjects is by thorough registration of vital and 
aortuary statistics. All births, deaths and contagious diseases should be accurately 
recorded. The cordial co-operation of physicians and undertakers should be solicited 
in making the data of these reports accurate and complete. It is desired to make these 
vital statistics an unanswer .ble argument in favor of systematic public sanitary work, 
and the granting of State and municipal funds necessary for maintaining such work. 
Prompt reports should be made to the Secretary of the State Board of Health, where a 
complete report of the State is compiled. Every locality should secure to its inhabitants 
homes so healthful that they would defy the potency of filth diseases. It is incumbent 
upon the health officer to see that all nuisances are abated, not only those which are 
detrimental to health, but those that are offensive to the sight or disagreeable to the 
sense of smell. , 

A few years ago an effort to instruct the public in the management of their own 
homes, such as plumbing, drains, cisterns, cellars, water supply, light, heat and clothing, 
especially any intimation that kitchen, yard, alley or out-houses were filthy, would have 
been regarded as an impertinence. Such suggestions are now received, often solicited, 
and made the basis of action. It is the duty of the health officer to keep the public in- 
formed as far as possible on these subjects. Where not otherwise provided for, he should 
inspect dairies, slaughter houses, slops, water and food supplies for animals, and kiadred 
subjects relating to public health. 

He should also collect scientific data in regard to altitude, climate, water supply, 
density of population, sewerage, proportion of sewered and non-sewered areas, and other 
points bearing on the healthfulness of the place, which will permit of interesting com- 
parison with the sick and death rate, and he should trace, as far as poBsibl,e, the source 
and means of conveying diseases. He should be familiar with the health laws of the 
State, with the rules and regulations of the State Board of Health, and see that they are 



264 ANNUAL REPORT 

properly and promptly enforced. Wherever sanitary laws have been enforced, the death 
rate has diminished. Sanitary rules are worthless if not faithfully executed, and yet no 
class of laws is so diificult of enforcement as those designed to protect the public health. 
In their practical application to be effective in the control of contagious and infectious 
diseases, individual rights, religious observances, commercial interests, and even national 
customs, must be subordinated to the exigencies which these pestilences create. It has 
been held that health laws are anomalies in civilized governments. They arbitrarily 
set aside ordinary laws because they are adapted to anomalous conditions of the people. 

Section 2136 of the Revised Statutes of Ohio reads as follows: 

"It shall be the duty of the board of health, or health department, on or before the 
first Monday of March in each year, to make a report, in writing, to the council of the 
corporation and to the State Board of Health upon the sanitary condition and prospects 
of such city or village, which report shall contain the statistics of deaths, the action of 
the board and its officers and agents, and the names thereof for the past year; and it 
may contain other useful information, and the board shall suggest therein any further 
legislative action deemed proper for the better protection of life and health; and it shall 
be the duty of said board of health, and health departments, to promptly furnish special 
reports as may be called for by the State Board of Health." (O. L., Vol. 90, March 
14, 1893.) 

This is an important section of the State law, and the health oflScer should see that 
it is fully complied with. 

To recapitulate, the health officer — 

1. He should be a physician where possible. 

2. He should keep the local board of health informed on sanitary matters. 

3. He should placard and quarantine contagious diseases. 

4. He should notify the principal of schools, or school teacher, of contagious 
diseases. 

5. He should see that places where contagious diseases have been are properly dis- 
infected. 

6. He should prohibit public funerals when death has occurred from contagious 
diseases. 

7. He should require a burial permit in all cases. 

8. He should see that accurate records are kept of births, deaths and contagious 
diseases. 

9. Prompt reports should be made to the Secretary of the State Board of Health. 

10. He should inform the public on sanitary matters. 

11. He should inspect dairy and food supplies. 

12. He should collect scientific data. 

13. He should trace the source of disease. 

14. He should be familiar with, and enforce the health laws and rules of the State 
Board of Health. 

15. He should make a complete and comprehensive annual report. 
I thank you, gentlemen, for your attention. 

The Chair: Gentlemen, this paper is now before you for discussion. 
It is desired that every paper presented shall be fully discussed. That is 
what we are here for. I think it would be desirable to have short speeches 
in order that each may have a chance to say something. 

A Member: Mr. Chairman, I move the time be limited to five 
minutes. (Motion seconded and carried.) 

The Chair : I would request that all rising to speak for any purpose, 
shall speak distinctly, so that the stenographer may be able to accurately 



OHIO STATE EOARD OF HEALTH. 265 

report the remarks that are made. Also, please give the name so that 
the record of the proceedings will show who has taken part in the discus- 
sion of the various subjects on the program. 

This paper is now before you for discussion. It is in my opinion a 
very important subject, and I hope that some of you who have had ex- 
perience will say something on the subject. 

After the lapse of five minutes, no one desiring to discuss the subject, 
the Chair announced the next topic. 

HOW MAY THE HEALTH OFFICER OBTAIN COERECT AND FULL NAMES 

OF INFANTS? 

{Proposed by Board of Health of Hart well.) 

Discussion opened by Dr. W. B. Hedges, Health Officer, Delaware. 

Mr. President: The question proposed, "How may the health < fficer obtain cor- 
rect and full names of infants?" might, in the present state of afiairs, be very properly 
answered by asking the question, "How may health officers obtain a report of the birth 
of a child at all?" It is a notorious fact, that this requirement of the health depart- 
ment of municipalities is almost totally ignored by physicians and midwives. It is 
only in the larger cities that birth reports can be obtained, and I believe that I am safe 
in making the assertion that the rule of the State Boaid of Health requiring mortality 
reports, is to an equal extent violated; hence vital statistics, as now obtained by our 
State Board of Health, are totally unreliable and worihlees for the purposes intended. 
The State Board of Health is doing all in its power to correct this evil, but with the 
limited authority it has, cannot be expected to accomplish the desired end. The law 
creating boards of health would appear in theory a sufficient guarantee to secure a full 
and satisfactory report ot vital statistics, but, practically, it is to a great extent a failure. 
How many municipalities in the State report to the State Board of Health statistics of 
any sort? I will venture that not one in fifty do it. The law now constitutes township 
trustees boards of health, with about the same authority possessed by boards in towns 
and cities ; but how many townships in the State return to the State Board a report of 
vital statistics — very few, I fear. What is the matter that such a stale of affairs should 
exist? Something certainly is wrong, either with the law itself or the execution thereof. 
Both are perhaps at fault. Now, if we cannot obtain reports of births, as now required, 
how can we hope to get such a report with the addition of the full name of infants, thus 
adding very gr<-atly to the trouble of making such reports. In this matter we must look 
chietiy to physicians for aid. My experience has been such as to cause me to feel that 
little can be hoped for from the medical profession in this line under the present laws or 
regulations. Many physicians refuse to make reports without remuneration, others, for 
various reasons best known to themselves. In fact, I have found many physicians 
opposed to nearly all of our health regulations, and especially birth reports, for they 
will tell you that the assessor looks after the births in his rounds once a year, and many 
other excuses are ofiered for the purpose of avoiding the little trouble it makes them to 
fill out the blank furnished by the board of health. I am well aware of the fact that 
boards of health and health officers have the power delegated to them by the authority 
creating thetn to prosecute delinquents; but, after all, this is a very unpleasant thing to 
do, especially in the smaller places. The health officer is usually a physician, and he 
will hesitate a long time before arresting a brother physician, one that i=, perhaps, his 
warmest personal and professional friend. The duty thus devolving upon him is a very 
unpleasant one, and one from which the bravest may shrink. To obtain the full names 
of infants, it appears to me that we must look to other sources than physicians and mid 



266 ANNUAL REPORT 

wives. A State law making it obligatory upon parents to report to the health officer or 
board of health, the full names of infants, with sex, date of birth, etc., within a certain 
spec^fi d time after birth, with a severe penalty attached in case of failure to comply 
with such law, might, perhaps;, secure the desired end. But I am fully convinced of the 
fact that the collection of vital statistics will not be full, and ai vthing like complete, 
until the United States government takes the matter in hand and passes such laws as 
will make this subject uniform throughout the country. 

A national board of health should be established by Congress, and a commissioner 
of health or national health i fficer appointed, and made a cabinet officer, whose duty it 
shall be to administer the national health law,-;. Boards of heal h should be required in 
every State and territory, and made auxiliary to the naiional board, and municipal and 
township boards auxiliary to the State boards. The State boards should be required, 
under heavy penalty, to make returns of vital statistics, contagious, i fectious and epi- 
demic diseases. To State boards should be delegated authority to coir pel township and 
municipal boards to f lithf ully report such statistics. Laws gov ruing the health depart- 
ment of the country should, to be effective, be made by the national government, and 
executed under the supervision of a national health officer. If such laws can be made 
under our peculiar form of government to not coLflict with the Con-titution, and at the 
same time apply to the Slates, they could be much better enforced than State and 
municipal act-. Moreover, it appears that laws governing the collection of vital statistics 
should be uniform throughout the Union to make such stuisrics valuable, upon which 
to base an estimate of the health, etc., of our people. In this way only can the question, 
" How may the health otHcer obtain the correct and full names of infants? " be answer* d. 

The Chair: This paper, gentlemen, is now before you for discus- 
sion. I would like to have each paper thoroughly discussed. Are there 
any remarks ? 

Dr. Waltz, of Collinwood : There are some things contained in that 
paper with which I agree, and others I don't like at all. In the first place 
it lacks backbone. Now, it seems to me that if the law is properly enforced 
such records of vital statistics could be obtained. In the first place you 
can pass a resolution requiring physicians to report, and if they do not 
report, arrest them. About a year ago I found a number of physicians 
who did not report their cases. I simply notified them that unless they 
reported every one of them, they would be arrested. 

There h another thing I think is worse than all that, and that is to 
get reports of births where physicians are not employed. There are a 
number of that kind of cases. I say that a physician that is a health 
officer should have plenty of backbone, and I believe that is all we want 
and need — to have the moral courage and not be afraid to make them 
come to time, and they will think as much of you in the end. 

The Chair : Are there any iurther remarks ? 

Dr. Hoover, of Columbus : What I am going to say might, perhaps, 
place me in a peculiar position, being a member of the State Board of 
Health, and consequently desirous that all of its rules shall be properly 
enforced. You may think strange that I am going to present a plea in 
behalf of the violators of some of the rules, but I am a doctor also. I 
want to state in the beginning that ([ was going to say ninety per cent., 



OHIO STATE BOARD OF HEALTH. 267 

but I guess, perhaps, I will not miss it very much when I say one hun- 
dred per cent ) of everything that is done for the benefit of the public 
health is done by the medical proiession, and it has been done in the face 
of the strongest opposition from the very persons who are most bene- 
fited by it. I have been a member of the State Board since its organiza- 
tion, and the laws that have been passed since the original bill have been 
secured by most persistent efi'ort on the part of those interested in sani- 
tary science, and they have been almost without exception doctors. 
Whenever we can educate legislators up to the point where the value of 
the life of an individual is regarded anywhere near equal to the value of 
a short-horn bull, then we may expect to get such laws passed as will 
preserve the public health. The very minute anything is done looking 
toward the conservation of the public health, the very minute a bill is 
offered in the Legislature, that very instant it is announced that it is 
some doctor's measure, and they proceed at once to kill it. Doctors have 
enough to do, and they do more than their duty every time without hope 
of reward ; and if they did not, God help humanity. While I £.dmit, and 
this may make my position seem somewhat anomalous, it is a rule of the 
State Board of Health requiring doctors to make these reports, and 
while I am glad to see that some of our health officers have pluck, I 
want to say frankly that there is no use in going behind the fact that it 
is a successful case of blufif, and it is not anything else. I question very 
seriously if any doctor could be compelled to make that report without 
compensation. It is a question of personal right that has never been 
tried as yet. I say this before a class of men in whom I have confidence 
enough to believe that they are not taking advantage of anything of that 
kind ; we are here not because the law says we shall meet here, but 
because every one of us has enough interest in the public health 
to take the time and bear the expense to come here and discuss 
matters of public importance. I believe, gentlemen, that it is the duty 
of the health oflicer to collect these names, and I believe that he 
ought to be paid enough to justify him in getting the names. 
I think Dr. Hedges' paper a good one, and I think Dr. Hedges 
lacks just about as much backbone as I would lack, simply be- 
cause there is the fact that stares you squarely in the face, that you can 
not require labor of anyone for nothing. Try it on the laboring man if 
you want to find out. You come to the doctor, as our friend over there 
said, and you say, " You have got to report so and so, or I will have you 
arrested." Why, the doctor simply reports. In the first place, because 
he is wholly a man and he doesn't want even to shrink from such a 
small duty, however irksome it may be. Secondly, because he is ac- 
customed to work for the good of humanity without hope of reward. 



268 ANNUAL REPORT 

Dr. Davidson, of Hilliards ; I want to say that I am in favor of 
backbone as much as anyone in the world. There are a number of 
cases which are not attended by physicians, especially among the German 
people, and I don't know what we would do if we had to run around 
and look after names. If we were paid for gathering these statistics we 
would make the effort. I think Dr. Hoover is right, that we ought to be 
paid, and it is not our duty unless we are paid. 

Dr. Ebright, of Akron : Some things in that paper I agree with, 
and with some things Dr. Hoover has said ; other things he has said with 
which I do not agree. First, I do not agree with the doctor when he 
says that all physicians, or that any physician does more than his duty. 
I don't believe that any man who follows a profession like this, the med- 
ical profession, can ever do more than his duty as a citizen. He may 
possibly do more than he should do so far as his family is concerned, but 
I don't believe that he can do more than his duty. The question, how- 
ever, is not as to whether Dr. Hoover is right. It occurs to me, in my 
experience of a number of years in the health office of a populous city, 
that it is not much trouble for a health officer to do anything he wants 
to do. In the first place he should understand that in an epidemic or 
anything of that kind the people will, so far as they can, aid him 
in doing 'that which is best for the interest of themselves and their chil- 
dren, and the health of the community. I believe that every health offi- 
cer can secure the hearty co-operation of every physician with whom he 
comes in contact. In the first place the physician through education, 
gets to be a generous-hearted animal, and is willing to do anything he 
can to assist a brother physician in carrying out what the physician 
deems to be his duty. Now as to vital statistics, the birth statistics ; I 
promise you, gentlemen, that next year there will be a report of nearly 
all the births in my city ; they will not fall short five. Our board is 
now preparing an ordinance for that work. We will send every physi- 
cian in the city a blank book on which in a minute and a half he can 
place the birth, the name of the father and mother, the residence, and 
date of birth, and drop it in the postoffice. The busiest man I can find 
is the best man I can get to do what I want done. A busy man is an 
energetic lellow, and is ready to work. A man who has no business is 
either idle irom necessity, by rea?on of his indolence or a lack of quali- 
fication. An energetic doctor always has business, and is always willing 
to do everything he can. God bless the doctors. They are always wil- 
ling to work. They don't get blessed in the right way. They get blessed 
enough in one way, that's true. The busy physician will always find 
time to make out his report, and I want to say to you that the busiest 



OHIO STATE BOARD OF HEALTH. 269 

phyeician in the city of Akron with whom I come in contact as health 
officer, is the first man to send in his report. 

Dr. Hoover, of Columbus: I want to ask our friend from Akron if 
that is not an exceptional town. [Laughter.] 

Dr. Bridinger, of Tiffin : I cannot exactly agree with what the doctor 
said in his paper. I think it is a little "off," defective in some things, 
in other matters it may be all right. I believe very much the same as 
does the gentleman who just sat down. I have been health officer of 
Tiffin for ten years, and I can say that I have had no difficulty in collect- 
ing reports of births and deaths. Neither do I find any difficulty there 
to have physicians report contagious diseases. We are working in unison, 
and it is true, as the gentleman said a moment ago, it is the energetic 
physician, the one who has the largest practice, who is willing to work 
and who can be relied upon for first reports. I would not hesitate a 
moment to arrest a physician, although I am one myself, if he did not 
comply with our rules and regulations. A short time ago I had a physi- 
cian arrested for failing to report a case of scarlet fever — physician and 
his son. The rest of the physicians, twenty-four in number, stood right 
by me and said I was right, because this physician and his son were neg- 
ligent in reporting. The only trouble is the collection of births, but for 
the last four years I have not had much trouble because I collected them 
once every month. I have been since the first of January collecting reports, 
and they are not all in yet. A good many feel that they should be com- 
pensated for it. My idea is, and I shall lay it before the next board meet- 
ing, to furnish the physicians with postal cards, and whenever they attend 
a birth instruct them to fill the card out and send it in. I am satisfied 
in that way we will get every one. Really I don't think I have missed 
five births in the five years. I have never had any difficulty in getting 
the physicians to co-operate with us in the matter. 

Dr. Young, of Chicago Junction : That is very much the same sys- 
tem we have adopted at our place. I furnished each one of the physicians 
a blank, together with a stamped envelope. Every month the report is 
sent to me. Physicians failiiig to report, I see personally, and it is re- 
quired that the undertakers shall procure the doctor's death certificate 
before the burial of a person, consequently I have reports of every death. 
Those are filed away every month. 

Dr. Shaw, of Sidney : That is about the same kind of an arrangement 
that we have in our place. The health officer receives SlOO per year for 
his work. I remember a iew years ago that there was a case of contagious 
disease in the family of one of our citizens, and the physician neglected 
to report the case, as was his duty, but our health officer notified him to 
appear before the board and show cause why he did not make the report, 



270 ANNUAL REPORT 

and since that time we have had no trouble at all, and our reports are 
made in due time. 

Dr. Hopkins, of Ashtabula : I have been much interested in the dis- 
cussion. I agree with Dr. Ebright in regard to the matter. The fact is 
this : We can all get, if we are trying and working on the right track, 
the reports without any trouble. I find that in our city a few of the births 
have not been reported, for the reason that we have quite a good many 
foreign population. Among those we have many midwives, from whom 
I get reports. Our physicians, to a man, have come down with their re- 
ports very well. I adopted this plan : I furnished them a postal card 
on which to make their reports to the health officer of births and deaths, 
and receive the reports in twenty-four hours. I also compel certificates 
to be furnished undertakers beiore they can bury the dead, and I get the 
deaths in that way also. I get reports very thoroughly, I think, from all 
our physicians. It is difficult for us at all times to obtain reports of births 
where there is not a recognized physician or midwife in attendance. It 
is supposed to be a State law, or an inflexible rule of the State Board of 
Health that our physicians shall report, that they must report, under the 
law. If Dr. Hoover thinks that there is no compulsion about that, and 
thinks they could not be compelled to make reports, what is the use of 
our State Board making such rules ? We have made rules to correspond 
as far as possible with the rules made by the State Board of liealth. We en- 
deavor to strictly live up to them. If a doctor in my place should refuse to 
make a report, I would have no hesitancy in promptly arresting him. I 
don't care whether he is a doctor or what he is ; that is my dut3\ Now, 
if you should say to me, " Arrest and be hanged," I should feel a little 
chagrined. If we can't back that thing up, I want our State Board, 
Brother Hoover, to back out and say that that law is not law. 

Dr. Hoover, of Columbus : I think the gentlemen have been a little 
off on this paper. This paper does not refer to the report of births. It 
did not say anything about that. How many of the health officers get 
the accurate and full names of infants? In Columbus, even such an ob- 
scure town as this, we succeed in getting more or less accurate reports of 
births, but I know of two or three instances where I was a party to the 
transaction that the child has not been named yet, and I am not going 
to find out when it is. I don't think you can compel me to. Now, as 
far as the enforcement of the law is concerned, that is all right, and I am 
glad to find out that so many of our brethren have got backbone. So far 
as the reporting of births is concerned, that is all right, but I will not go 
around and ascertain the name or name the child. Now, gentlemen, 
speak to the point. 



OHIO STATE BOARD OF HEALTH. 27 1 

Mr. Truex, of New Straitsville : At our place I get accurate reports, 
I think, of births. What bothers me is to get the names. I was assessor 
five 3'ears, and I ran across a child five months old that was not named. 
I named it for them. I would like to find out how to get the names. So 
far as the births are concerned, I get them every month on blank certifi- 
cates furnished for that purpose. 

A Member : As Dr. Hoover has said the paper refers to the obtaining 
of the full names of infants The law of the State, if there is a State law 
upon the subject, requires all births reported within the first ten days of 
the month succeeding that in which the birth occurred. I believe that is 
the substance of the State law on that point. Very few children are 
named within ten days after they are born, and sometimes longer, in 
which case it is of course impossible to obtain the name. The important 
thing is to record the births and names of the parents. In my experience 
as health officer, there has been no trouble whatever to obtain reports of 
births, but the greatest difficulty I had was in obtaining reports from 
physicians. They are verj negligent in regard to reports. 

Dr. Hedges, of Delaware : I have been much entertained with this 
discussion. I desire free discussion and free criticism of what I say. My 
own experience has been rather unfavorable in the way of collecting 
reports. In our town we have twenty-five physicians and four or five 
undertakers, and in some manner the reporting of vital statistics and 
statistics of contagious diseases and deaths has dropped out. But I 
became health officer and I have endeavored to have it re established on 
a sound basis, and 1 hope yet to have it done ; but up to the present time 
it has been a failure. Oar undertakers have refused to a-k for burial 
permits. Some of our physicians refuse to make reports ; and I will dis- 
agree with some of the previous speakers that it is the busy physician 
who gives the best attention to reports. I find it the other way. One 
who has the largest practice in the town refuses to make the required 
reports. Of course, I can have him arrested, but it is not a pleasant thing 
to do. I have asked our board of health to support me in having these 
rules strictly enforced, and am sorry to say I have failed to get the support 
that I expected, but hope yet in the future to do so. As to obtaining full 
names of infants born, I do not see how we can do such a thing. I have 
no idea that any such a rule could ba enforced at all to be anything like 
satisfactory. 

The Chair : The next paper on the program, gentlemen, is a paper 
by Dr. Ebright, health officer of Akron. I will say, in explanation, that 
when this letter was transmitted to Dr. Ebright asking him to open this 
discussion, the word "school" was omitted, and he has prepared his paper 
on the ventilation of public buildings. 



272 ANNUAL REPORT 

TO WHAT EXTENT, IF ANY, IS A BOARD OF HEALTH AUTHORIZED TO 

REGULATE THE SANITARY CONDITION— LIGHT, HEAT 

AND VENTILATION— OF SCHOOL BUILDINGS? 

(Proposed by Board of Health of Sycamore.) 

By Dr. L. S. Ebright, Health Officer, Akron, O. 

Mr. Chairman and Gentlemen: I want to tender my sincere thanks to the 
President for the kind apology made to you for me. However, there is another thing he 
omitted to say in connection with this paper and myself — to apologize for selecting me 
to open this discussion. Why a doctor should have b^en asked to discuss questions of 
law I can't understand. I have studied law, but do not discuss it very much, and if you 
gentlemen want to disagree with me, I have no objection. However, I shall do the best 
I can and leave the matter with you people to rake me over the coals as we did Bro. 
Hedges. [Laughter.] 

The importance of any branch of sanitary science in connection with the powers of 
boards of health may be determined, first, by the dangers arising from unsanitary con- 
ditions; second, the number of persons who may be affected by such conditions; third, 
the expenditure necessary to a fair and impartial transaction of the business involved, 
measured by either of these standards. The subject before us is of exceeding importance 
to the people of this great commonwealth, and especially to those residing in our most 
populous towns and cities. First, because it involves, as is indicated, the power of 
boards of health to regulate and improve the conditions of all public buildings, namely, 
places where the people generally are in the habit of congregating. Secondly, the health 
and comfort of not only those who frequent these places, but of all with whom they may 
come in contact. 

With the former we have most to do in this discussion. And, indeed, to discuss the 
latter in all of its multifarious forms would require more time and space than would be 
allotted to us, since I take it that our worthy President does not intend a s.ngle individual 
to monopolize all the time of this meeting. 

It will be impossible, however, to discuss the subject intelligently without inquiring, 
first, as to what the rights of the public are in a moral sense. It is presumable that our 
law makers, when framing a law, take the moral rights of the people into consideration, 
and endeavor to enact laws that will secure these rights, regardless of the few who may 
feel that they are being injured or imposed upon. 

What then should be the rights of the people morally? First, they should have 
the right to say, through properly appointed officers, where public buildings should be 
located in order to secure the best sanitary conditions. These, of course, consist of 
sewerage, ventilation, light, heat, cleanliness, modes of ingress and egress; and there can 
be but little doubt that our Legislature intended that such powers should be vested in 
the State and local boards of health. 

And, while it may be offered that the language of the sections which I shall take 
the liberty of quoting you presently is, perhaps, somewhat ambiguous, I believe it is an 
axiom in law that the legislative intent is to be considered in the construing of it, as 
well as the language itself. 

The genesis of the law, in so far as the rights of the people under this government 
are concerned, is to be found in the Declaration of Independence, our magna charta of 
civil and religious liberty, and it declares in language too plain to be misconstrued, that 
all men are entitled to certain inalienable rights — life, liberty, and the pursuit of 
happiness. 

Now if life is one of our inalienable rights under the declaration, the framers of 
that document must have meant and intended that that life should be physiological, or 
as near that condition as it is pofsible for man to obtain, else they would not have added 
" the pursuit of happiness," since healthy life is one of the requisites of happiness. 



OHIO STATE BOARD OF HEALTH. 27| 

Assuming, therefore, that our interpretau'on of the language of the declaration it 
correct, we find that the rights of the people to protect themtelves in a sauitary sense art 
clearly establi-hed, and that there can be no (quivocation. 

Indeed, he who constructs a pubLc building in such a manner that those who occupj 
it from time to time, or who live in close proximity to it, are forced to breathe an atmofr 
phere so poisoned that they are in danger of malaria, typhoid fever or diphtheria, nat 
only rest-icts, but in fact deprives them of that which is their inalienable right — life. 
This, it is needless for me to say to an intelligent body like this, may be easily done, if tht 
sewers, drains and plumbing are so^construcied that siphons are formed, that ctS'pook 
are made instead ( f properly constructed trap.-, so th it gj^ses from the closets and sewent 
are carried into instead of out of the buJding. 

It is equ I'y important that the ventilation of such buildings receives the attentiofc 
of proper authorities. It is true, with the electric light sciet ce has be»n ihrowing upon 
the question of ventiNtiou, that there is at least the shadow of a doubt as to whether air 
that has be*'n breathed a number c f times is dangerous to life and bealih or not, bat 
since it is prov«-n beyond a p r»dventure <f a doubt that cuntagioun di-eases are frooE 
two to three times more numerous in tenement houses where bad ventilation and ba«E 
sewerage exist, and where the environments are generally bad, it is safe for us to assume 
that these are important factors in the production of disease and consequent deaths, an^ 
are, therefore, well worth our most careful study and investigation. 

No man in this presence, indeed, there is no intell gent or humane person anywliert 
but that will object most strenuously, and call in the aid of the law, if necessary, te> 
prevent his neighbor from scattering in a reckless manner such deadly agents as strychnu^ 
morphia, or other poisons, if his own or other people's children might come in contaci: 
with them. 

For nearly a century it has been accepted as a truism that vitiated air is dangeroac 
to health, a»d that the proper ventilation of living rooms, bedrooms and public build- 
ings of all kinds, is an important sanitary measure, and therefore calls for the highest 
architectural and engineering skill, and the most careful and comprehensive legislative 
enactments. 

With well grounded principles facing them on every hand, our legislators enactdtf. 
the following statutes covering this subject, and with these we have to deal in this dig- 
cussion. A careful examination of the several sections relating to the powers of State 
and local boards will, in our judgment, establish clearly the fact that their powers aa 
almost without limit, and that they are untrue to themselves and recreant to their datiee 
when they fail to examine carefully into the construction of public buildings, and ioBist 
that the sanitation of such structures be complete in the smallest detail. 

Section 2116 of an act entitled " An act to amend and supplement certain sectione 
of the Revised Statutes, relating to the powers and duties of the State and local boarde 
of health," provides that the board may compel the owners, agents, assignees, cccupante; 
or tenants of any lot, property, building or structure, upon or in which any nuisance 
may be, to abate and remove the same. It further provides that said boards may rega- 
late the location, construction, repair, use, emptying and cleaning of all water ciosetpj 
privies, cesspools, sinks, plumbing, drains, yards, pens, stables or other places whece 
offensive or dangerous substances or liquids are, or may accumulate. 

You will observe that while the language of this section does not explicitly refer to 
public buildings, it is so general in its description that they are necefsarily included 
for it says from any lot, building or structure, a nuisance may be abated, and ever 
indicates the parties liable for the maintenance of the same. It seems clear to OOK' 
mind that if the boards of health have power to abate a nuisance once found, it is alao 
within the jurisdistion of the board to prevent the formation of the same. 

This section further says that boards of health may regulate the location, consttac- 
tion, repair, use, emptying and cleaning of all water closets, privies, cesspools, sinkf, 
plumbing, drains, yards, pens, etc., etc. 

18 ST. B. H. 



2 74 ANNUAL REPORT 

Now, while we do not claim that this section does grant absolute power, we feel 
assured that the intent of the law, and especially of other sections to which we will call 
your attention later on, is being so clearly indicated that their power is made absolute 
by the act of 1893. 

This section, you will observe, declares distinctly that the board of health may 
regulate — what? The location and couEtruclion of all plumbing— not meaning, there- 
fore simply the plumbing in private buildings, but since it has failed to indicate the 
character of the buildings, it necessarily means buildings of a public as well as of a 
private character. It seems superfluous to add that the plumbing here spoken of must 
mean that of buildings, for the reason that work of that character is not done in open 
fields or lots. 

Section 2122 says, " The board of health of any city, village or township may make 
Buch orders and regulations as it may deem necessary for its own government, for the 
public health, the prevention or restiiction of disease," etc. We find here that any 
board of health may establish such orders and regulations as it may deem necessary for 
the prevention of disease. They have, therefore, the power to legislate in su(h a man- 
ner that the construction of a public building must be of such a character that its 
strength and sanitary condition are not such as to endanger life, or be conducive to 
the spread of disease. 

Section 2128 declares that, " When any building, erection, excavation, premises, 
business matter or thing, or the sewerage, drainage, plumbing or ventilation thereof, is, 
in the opinion of the board of health, in a condition dangerous to life or health, and 
when feny building or structure is occupied or rented for living or business purposes, 
and sanitary plumbing and sewerage are feasible and necessary, hut neglected or refused, 
the board of health may declare the same a public nuisance, and may order the same to 
be removed, abated, suspended, altered, or otherwise improved or purified, bv the owner, 
agent or other person or persons having control of the same or being responsible for the 
condition • and the refusal or neglect to obey sui h order shall be a misdemeanor, 
punishable as hereinafter provided " 

The hoard may also, by its officers and employes, remove, abate, suspend, alter or 
otherwise improve or purify the same, and certify the cost and expense thereof to the 
county auditor, to be assessed agaitst the property, and thereby made a lien upon the 
same and collected : s other taxes. 

This section is much more explicit, for it points out plainly the exact character of 
the building or thing — saying plainly : '' Aiiy building where the sewerage, drainage, 
plumbic" or ventilation is in sych a condition as to be dangerous to life or health." 

It seems evident to us that, in the very inception of this enactment, the legislative 
intent is clearly indicated, and that it is proposrd that boards of health shall have and 
are given power to regulate and control the sanitation of all public buildings, the first 
section apparently clearing the way for what eventually follows in the section just 
quoted. 

It may possibly be urged that no power is given to interfere in the construc- 
tion of a building, but it seems self-evident that a body of intelligent men would not 
place a destructive power in the hands of a man or body of men, without at the same 
time meaning that that same body should have also the constructive. Indeed we find 
but a single word in the entire section, which, in our judi^ment, limits in even the 
smallest degree, the almost absolute power of these bodies, and that is the word feasible, 
the language being," Where sanitary plumbing and sewerage are feasible and necessary," 
and even this is largely shorn of its strength further on, for this language is used: "May 
order the same to be removed, abated or suspended." Here the feasibility of drainage, 
sewerage and ventilation was not considered, but the question which seemed paramount 
to all others was : " Is the building or thing, by reason of faulty construction and lo- 
cation dangerous to life and health, and therefore a public nuisance? if so, remove 
or aba e it. 



OHIO STATE BOARD OF HEALTH. 275 

Section 2 of the act establishing the State Board of Health declares '* That the 
State Board of Health shall have supervision of all matters relating to the preservation 
of the life and health of the people of the State." 

In the entire domain of sanitary science are the people of the State no less inter- 
ested than in this special branch —the proper construction and sanitation of the public 
buildings of the State, and to the State Board of Health is given the power to delegate 
or transfer its powers to the local boards. 

Regretting exceedingly that your worthy Secretary was not more fortunate in se- 
lecting some one more capable to open this discussion upon so important a subject, ard 
especially where a point of law is involved, 1 leave the subject in your hands. 

The Chair : The paper is now open for discussion. This is a very- 
important subject, and one upon which I should like to hear considera- 
ble discussion. 

Dr. Davidson, of Hilliards : Mr. Chairman, it occurs to my mind 
that it needs no digcussion unless there is some lawyer present who is 
conversant with such matters. It might be proper to discuss the subject, 
but it seems to me that it has been discussed very thoroughly. 

Mr. Purinton, of East Liverpool: Mr. Chairman, concerning this 
paper just read, I wish to state that our board at present time is in con- 
troversy which relates to this subject. It is quite likely that a judicial 
decision will be arrived at regarding it. We have a hotel in our city and 
the sewer passes the rear part of it. The hotel is not connected with the 
sewer but has been using a cesspool. The board passed a resolution de- 
claring sewerage to be both feasible and necessary under that building, 
inasmuch as the cesspool has become filled up within four feet of the 
top — eighteen feet deep. The building is a frame structure of three sto- 
ries and sides of brick, and the matter was declared a nuisance. There 
is also another point involved that I will call attention to. The point is 
here. The owner of the building resides outside of the State. The 
building is occupied by a tenant. Is that tenant, for failure to comply 
with our rules, liable to punishment by a fine, and imprisonment if 
necessary, or are our hands tied so far as he is concerned ? There will be a 
judicial decision in the matter, because the parties interested are going to 
contest it. We are perfectly clear that we can clean this out, and as a mat- 
ter of fact we have cleaned it out and filled it up. But what about the 
plumbing ? We cleaned it out and filled it up, and have taken proper 
steps to certify the amount to the county auditor, and have.it placed on 
the tax duplicate. Now comes the question of complying with the re- 
mainder of the notice, that they shall put in the plumbing. The land- 
lord is out of the State, and the question is whether we can compel the 
tenant to put in sewer connections. We don't knosv that he is the agent. 
We want to make him do it if we can, and we are going to do it if 
we can. 



276 ANNUAL REPORT 

Dr. Hoover, of Columbus : I believe I web accused of not having 
backbone. Now here is where I have backbone. If you want my opin- 
ion, worth what it may be, the proper thing is to put that in and make 
them pay for it. If you put in plumbing there you can make it just as 
expensive as you please, and the next fellow will not let you put it in 
for him. 

Mr. R. S. Galleher, of Sycamore : Mr. Chairman, at the time the 
circular letter that was sent out by our worthy Secretary reached me, 
as health officer of S3'camore, we were in the midst of what I expected 
at that time to be important litigation, but since that time everything 
has blown over and at present is all quiet. We have one building there 
that has been complained of for some time. I speak particularly of the 
high school room. The building is not of the most modern construction. 
The room is about 28 by 30 feet, with a ceiling 13 or 14 feet high. The 
stove by which this room was heated was located in the center of the 
room. On either side of the stove within 23 inches I measured, the end 
of the seats stood within 23 inches of the stove. The stove is one 
of those large family stoves, somewhat higher than my head, and during 
the weather when it was necessary to have fires at all in the stove the heat 
became so disagreeable close to the stove that it was impossible for pupils 
to sit there. There were at that time 80 or 90 pupils in the room. The 
seats were somewhat similar to the ones we have in this room. 
Every seat in the room was occupied, and in addition to these chairs 
were put along the aisles. The ventilation of the room in the sum- 
mer time was all right, from the fact that on south and north there 
were large windows which could be raised from the bottom and also 
from the top, making the ventilation in the summer time very 
good. But in the winter time, in order to have any fresh air in the room 
at all it was necessary to either raise or lower the windows on the side of 
the room either north or south. When that was done pupils sitting next 
to the window got cold, and they had to come up closer to the stove. In 
order to make the room comfortable back a distance from the stove it was 
necessary to have a pretty good fire, so that it kept the school in a continual 
commotion. Now, then, our school board at Sycamore had been spoken to 
concerning this matter a number ot times during last winter. When school 
commenced this winter there was no chance made except instead of the 
seats running as they formerly did, across this way (indicating), they ran 
across this way (indicating). Now, school commenced, and the school 
board decided that they could not afford to make any change in the ven- 
tilation of the school room. We had three rooms that were about in that 
condition. The superintendent of the schools came to my office and 



OHIO STATE BOARD OF HEALTH. 277 

e 
wauted to know of me what could be done in the matter. He said ther 
seems to be a question of law connected with this, and if this ventilation 
can be improved I think it ought to be done. I want you, as health 
officer, to look after it. Weil, there was no question in my mind, because 
I had considered the matter, and I met the school board at their *next 
meeting and laid this proposition before them, and that was that one of 
two things would happen, and that very quick, that those school rooms 
should be properl}'^ kept and ventilated or the school stopped. That was 
about what I said to them. I 'did not make any further explanation, 
because I well knew that they had been talking about the matter and had 
been considering it, and the only reason they could give me was that they 
had not money enough to do it with. We all well know the fact that a 
great many of the diseases of children are contracted in the school room, 
and we should, therefore, have the school rooms properly ventilated and 
heated, especially this time of the year; and it should be the duty of the 
school board, without any directions from anybody, to make a com- 
fortable place for the children while they are there. They held another 
meeting the following week and decided that they would not do anything. 
They said they could not possibly do anything because they had no 
money to do anything with. They came to me and had a conference. 
They did not want any trouble about it. At this stage of the game I 
received the circular letter from the Secretary and the question popped 
into my head to submit it for discussion at this meeting. I began to get 
uneasy about it. I have a boy in school myself. He would come home 
feeling sick and said he could not study because he had to sit too close to 
the stove or window. Now, gentlemen, there was no question but that 
they could get money. They certainly could have made arrangements 
to purchase a furnace, and the parties could wait until they had money. 
I wanted them to go ahead and fix it. They refused to do so at that 
time, and I expected litigation with regard to the matter. But they 
appointed a committee at the next meeting of the board. They investi- 
gated some school rooms there that were heated by the means of furnaces, 
and finally decided to purchase furnaces and put them in, and did so, and 
have them in perfect working order, and a nicer ventilated room you 
never saw. The teachers in the school room have each come to me and 
returned their thanks for the step I took in the matter of securing proper 
ventilation and heating of these rooms. I was very much pleased with 
the paper read by Dr E bright, because I believe that all public buildings 
should be looked after by boards of health. 

The Chair : Are there any further remarks on this subject? 



278 ANNUAL REPORT 

A Member: I move, Mr. Chairman, that we adjourn until after 
dinner. (Motion seconded and carried.) 

The Chair: The convention will take a recess until 2 o'clock p. m,, 
and it is desired that we shall promptly meet at that time. 



SECOND SESSION. 



Thursday, 2 p. m., January 24, 1895. 

Dr. Byron Stanton, President of the State Board of Health, in intro- 
ducing Governor McKinley, spoke as follows : 

Sanitary organizations have always been cordially welcomed to the 
capital of our State, and we felt assured that we would be welcomed here, 
but our Governor has done us the honor to come to our meeting to say to 
us in words that we are welcomed and to extend to us a hospitable greet- 
ing. I have the honor and pleasure of presenting to you Governor Mc- 
Kinley. [Applause.] 

Governor McKinley spoke as follows : 

Mr. President, and Gentlemen of the Convention : I am glad 
to meet the State Board of Health and members of the local boards of 
health, and to congratulate them upon the good work they have already 
accomplished, and upon the efforts they are making to do still better 
things for the health of the people of the State. They have resting upon 
them — all of you have resting upon you — the most difficult as well as the 
most delicate of duties. There can be no graver responsibility resting 
upon a public board than that which relates to the life and health of the 
people, and there is no better way of promoting the real welfare of the 
State than by promoting the health of the people. [Applause.] Public 
safety is the supreme law everywhere, and public health is indespensable 
to public safety. It is a source of great gratification to me, as I am sure it is 
to the people of the State at large, that we have a State Board, and back of 
that the local organizations, so able and active and vigilant, so thoroughly 
and scientifically equipped for preserving, as far as possiblee, the public 
health. The annual reports of the Ohio State Board show what a great work 
they are doing, and the interest in these respects is increasing from year to 
year. The statistics furnished are of the utmost value and importance, for 
they give to the health officer everywhere an experience to guide future 
action. We cannot, too strongly, gentlemen, — for I know something of the 
members— commend the State Board of Health. I have known of their 
work for now' three years, have followed it with the closest interest and 



OHIO STATE BOARD OF HEALTH. 279 

concern, and know they have accomplished nauch for the public good 
and for the welfare of the State. The whole State knows of the efficiency 
of the able Secretary of the State Board of Health. The Board has met 
every exigency that has arisen, and have done much to prevent the 
introduction of contagious diseases in the State. Another thing the 
Board has done: They have succeeded in dispelling a great amount of 
popular prejudice against the work of the State and local boards of health, 
and they have won the confidence of the people and of the representatives 
of the people, and in doing that they have accomplished one great essen- 
tial in the successful performance of any public trust. If they could have 
the earnest and active co-operation of the local boards, municipal and 
other public officers in every secuon of the State, they would still accom- 
plish better results for the people, and I am glad to learn that that co- 
operation is greater now than ever before, and is all the time growing. 
We are making great progress in sanitary education in this country, and 
the school of instruction has only just begun. We have yet much to 
learn. The papers which have been written and presented by members 
of the State Board and scientific men everywhere, have done much to 
educate the masses in this most important field, and with this it is made 
easier for the State and local boards to advance in their reform. Frequent 
meetings by the State Board and national and local boards will have a 
tendency to promote progress in the line of sanitary instruction. 

I am pleased, gentlemen, with this opportunity to be publicly associ- 
ated with you in a work of such vast importance. I thank you for the 
good you have already accomplished, and to bespeak for you even more 
satisfactory results in the future. I shall cheerfully co-operate with you 
in your work and efforts in every possible and proper way to aid you in 
securing the best results from your important official trusts. I bid you 
welcome to the capital of the State, and trust your sessions will be prof- 
itable, as I am sure they will be interesting and agreeable. [Applause.] 

Responding to the address of welcome by Governor McKinley, Dr. 
Stanton spoke as follows : 

Allow me to thank your Excellency, in the name of this body, for 
the hearty welcome you have just accorded us. I am sure I speak the 
sentiments of all when I say that our pleasure is greatly augmented and 
we feel much encouraged by your presence, and by the expressions of your 
favor that have been given. On behalf of this meeting I gratefully thank 
you for this cordial greeting, and on behalf of the State Board of Health I 
especially thank you for your words of commendation of the work it has 
accomplished. We look forward to a useful and important meeting. We 
feel that it is good for us to be here. We have come for a common pur- 
pose — an interchange of thoughts and opinions, and for a fair and 



280 ANNUAL REPORT 

impartial consideration of such subjects and measures as will tend 
80 lengthen life, prevent disease or mitigate suQ'ering. This is the fifth 
annual meeting of this sort, and their growing popularity has added 
greatly to our numbers from year to year. Good as have been the papers 
and discussions of preceding meetings, we indulge the hope that those of 
dhis year may be still better ; that this organization may extend its useful- 
ness by the thorough discussion of the practical questions that are set 
^ith in the admirable program arranged by our worthy Secretary. I 
sincerely hope that this may be an occasion of great interest and profit. 

As this is not a medical meeting, it may not be proper for us to con- 
aider here the immediate causes of the preventable diseases from a medical 
©3" bacteriological point of view, but there are remote or predisposing 
causes of great importance which, as they belong to preventive medicine, 
we may consider. Preventive medicine may be said to be of recent crea- 
tion. The men who have given it its scientific character are men of the 
present age. Its domain is enlarging, and this has much to do with the fact 
that, within the last quarter of a century, in nearly all civilized countries 
the death rate has been lowered, the duration of life materially increased, 
and living freed from many of its pains and terrors, and it is believed 
that the time will come when many of the diseases now termed " prevent- 
able " will be extirpated. While some of the lowering of the death rate 
may be due to improvements in medicine and surgery, much of it is due 
to public sanitation, and this beneficent work is the chief glory of modern 
medicine. 

The importance to the State, especially to villages and rural districts, 
of the law for the compulsory establishment of legally constituted local 
health authorities as a means of protecting life and health, is becoming 
more and more apparent. But little opposition to the law is now mani- 
fested. The law was in advance of public demand, but the criminal 
indifference and ignorance, which were formerly the worst enemies of 
sanitary science, have given place to a better state of affairs. The general 
public has been educated to the real value of this sanitary legislation. A 
few boards have been ignorant of their prerogatives, and declined to act, 
but the health laws have been pretty generally enforced, and it is hoped 
and believed that with increased experience, a greater uniformity of san- 
itary organization and a fuller registration of vital statistics throughout 
the State, interest will be added to the work and greater value given to 
©or reports. The thorough organization of the sanitary authorities and 
health officers under the present law has resulted in much good, and not 
only are the laity being educated to the importance of sanitation, but in 
the medical professsion the great problems involved in the prevention of 
disease are being more studied, and our medical colleges are better educa- 



OHIO STATE BOARD OF HEALTH. 28 1 

ling their students in hygiene. The present era of medicine is preemi- 
nently distinguished as aimiug rather to prevent than treat disease. 

The State Board of Health has been industriously at work in the line 
of its duties. It has sought to awaken public attention to the danger of 
neglecting that cleanliness which is akin to godliness; it has collected, 
classified and distributed information looking to the conservation of 
public health, and has ever encouraged and co-operated with local boards 
in this interest; it has published and Ireely distributed among local boards 
and the people, circulars on the prevention of consumption, diphtheria, 
scarlet fever, typhoid fever and small-pox; it has collected and published 
the vital statistics from the difierent parts of the State ; it has investigated 
local outbreaks of disease; the members of the Board and its Secretary 
have visited many places in the State to make investigations in regard to 
special causes of sickness, and to inspect new systems of water works or 
sewers; it has by committees, inspected several of the public buildings in 
regard to which complaints as to their sanitary condition have been re- 
ceived, and called attention to their defects and advised as to how they 
might be remedied. Wherever outbreaks of the more dangerous infectious 
diseases have occured, our Secretary or some member of the Board has 
gone to render the local authorities such assistance as was in bis power to 
prevent the spread, and it is a matter of congratulation that the greater 
diffusion of knowledge in regard to the prevention of these diseases 
through the State, and especially those clothed with power in such matters, 
has rendered such visits less frequently necessary than in former years. 
Of some of these outbreaks special reports will be made during our meet- 
ing. The Board has endeavored, as far as has been in its power, to dis- 
seminate knowledge among the people upon matters relating to public, 
municipal and domiciliary hygiene through the Monthly Sanitary Record, 
the publication of which was kept up so long as the financial affairs of the 
Board would permit, but the reduction of our appropriation by the Legis- 
lature, from ill-judged motives of economy, compelled us to give up this 
important work, which we would be glad to resume if we were able so to do. 
Statistics could be adduced to show that the kind of sanitary work 
done by the health organizations throughout the State yields a rich reward 
lor the dollars and cents expended, but even if my time were not too 
limited to permit me to give such statistics, it would not be necessary 
here, for you are as well aware as I am of the fact that sanitary work is 
accomplishing its object in a way that yields a good profit in the preser- 
vation of life and health. 

If, in carrying out the programe arranged for this meeting, we are 
able to disseminate useful knowledge, if we are able to bring out thoughts 



2S2 ANNUAL REPORT 

and suggestions of a practical nature, which we may work out after going 
to our homes, our meeting will have yielded good fruit. 

On behalf of this body I again thank your Excellency for the warmth 
of your welcome, a welcome which we hope not to abuse. We will not 
take the atmospheric temperature of this January day as an indication of 
the warmth in your heart. [Applause.] 

The Chair: ('cntlemen, the next subject for discussion is one pro- 
posed by the Board of Health of Bucyrus, namely, "The Best Means for 
the Prevention of Tuberculosis in Man and Animals," the discussion to be 
opened by Dr. D. N. Kinsman, Health Officer of Columbus. 

Dr. Kinsman : Mr. President and Gentlemen of the Public Health 
Association of Ohio: Consumption, two hundred years ago, was believed 
to be contagious, and the first book yritten on consumption in the English 
language held that view. Morgagni said while young he feared the bodies 
of those dead from consumption, and when old he avoided them. There 
was no question as to the contagiousness of consumption until about the 
time that ' ir Thomas Watson gave his lectures on the practice of medicine. 
The inocubility of consumption or of tubercles was demonstrated in 1865 
by Villemin. In 1882 Koch discovered the bacillus known by his name. 
This he isolated, cultivated, and inoculated, and thus proved this bacillus, 
and this alone, was the cause of consumption. Before there were many 
factors supposed to enter into its cause, as poor food, bad air; in other 
words, physiological poverty or misery in the world, and without which 
consumption would be a thing of the past. These we know may prepare 
a soil on which the bacillus may grow, but without which bacillus con- 
sumption never exists. All warm-blooded animals are subject to tuber- 
culosis. Some resist it better than others. Some, like the Gerbille, are able 
to resist it completely. Men have various degrees of resistance ; some yield 
easily and some resist very strongly. Tuberculosis may be communicated 
by the process of respiration, digestion or by inoculation. This tuberculous 
material is produced in the lungs. It is spat out upon the ground, or upon 
the floors, or upon the walls of buildings. It becomes pulverized, and it is 
carried by the air. It is inhaled. It effects a lodgment in the lungs, and 
there it grows. This expectoration thrown out upon the ground has been 
known to be dried and wet, alternately for six weeks at a time, and yet the 
game material mingled with the dust of the street has been inoculated and 
proven fruitlul at the end of this time. All our flesh-producing animals are 
subject to tuberculosis. The sheep is the most resistant of all, but it has 
been inoculated. Cattle feeding in the same manger where cattle have pre- 
viously had tuberculosis and died, have become infected by inhalation of 
this tuberculous matter that was left by the former occupant of the 
manger adhering thereto. Animals, kittens fed upon the milk of tuber- 



OHIO STATE] BOARD OF HEALTH. 283 

culous C3W8 have become tuberculized. Dogs who have licked the 
sputum of their tuberculous master have become tuberculized and died. 
Calves fed upon tuberculosis matter from men and other animals 
have become infected. Fowls also [have become infected by devouring 
tuberculous infected food. Having ascertained that the tubercle bacillus 
is the cause of consumption, that it is reproduced in persons who are 
affected with it, that the bacillus is spat out of the lungs of those pereons 
who are infected, and that every person who is affected with tubercles is 
the focus for further infection, ^it is evident|that hygienic measures will 
have much to do with the spread of this disease. How important this 
subject is, may be recognized.by the fact that one-seventh to one fifth of 
the entire mortality of any community is due to tuberculous diseases. 
How shall we prevent this ? Every patient should be quarantined, not 
isolated ; and they 8hould|be instructed^to carry with them a receptacle 
that contains a disinfectant, into which allof their expectoration, charged 
with bacilli as it is, can be thrown. They should be instructed that they 
should not soil cloths withjtheir sputum without burning them, or spit 
upon the floors of the rooms in which they reside. There should be a 
systematic inspection of all flesh that is used for food in order to prevent 
contamination by way of the digestive organs. That the spread of 
tuberculosis in the human race depends to no small extent upon infection 
by the milk of cows, may be readily inferred when we recall the statement 
of Fleming that the majority of cows above seven years of age are tuber- 
culized. There ought to be specific legislation looking to the inspection 
of all our meat-producing animals. 

The Chair : Gentlemen, we have now one of the most important 
subjects for discussion that will come before us. I think it would be prof- 
itable for us to thoroughly discuss it. 

Dr. H. L True, of McConnelsville : I fully concur in Dr. Kinsman's 
remarks. I think I have observed cases of infection that might have been 
prevented had the people been informed. I wish to relate one that occurred 
in our town. A young lady came back from the West and stopped at 
her sister's in McConnelsville. There was no consumption in the family 
that they knew of before that, and she must have brought the infection 
with her. She lingered for some time and died. Her sister did not use 
the feather bed she lay on after that, but she put it away for another sister 
that was going to school at that time some place in Tennessee. After 
awhile that one came home, and got married, and her sister gave her the 
feather bed that the other one died on. She took that, and she slept on 
it one winter, and next spring she took the disease and died with it. I 
was called to see her, and called attention to that, and, as I mentioned it, 
the sister was satisfied that that was the way she got the disease. Now, 



284 ANNUAL REPORT 

in Dr. Whittaker's practice, he stated that in Berlin attention was called 
to feather beds as a source of tuberculosis. They took the feathers out of 
a bed that a patient had died on, and sent them to the renovator and had 
them renovated by five diflerent renovators in the usual way, and even 
after the feathers had been renovated they gave consumption to nearly 
every one who slept on them. Now, it seems to me, gentlemen, that the 
days of feather beds have about gone by, and I would like to have the 
State Board of Health say a word upon the subject. 

Dr. Young, of Chicago Junction: About sixteen months ago I had 
in my care a young boy twenty years of age, who came home from school 
and was in very poor health. On examination it proved to be tubercu- 
losis. Death ensued in a few months. There is no history of tuberculosis. 
in the family on the father's or mother's side. To-day the father is dying 
with tuberculosis contracted from that case. The time he came into my 
care they were in the habit of spreading newspapers on the floor and 
allowing the young man to expectorate on the newspaper; of course, 
when he came under my care that was changed. I had them procure 
spittoons and use them. They were thoroughly disinfected, the expec- 
toration being thoroughly cooked, but it was too late. The father is 
slowly dying of tuberculosis. The sisters broke down and were sent 
away. Whether the mother will escape it or not is a question. I am 
satisfied that it is contagious, consequently I have taken all precaution 
possible in the care of those afflicted with tuberculosis, and I am very 
anxious to have this matter discussed at great length, because I am deeply 
interested. 

Mr. Hartzell, of Canton : I have never heard the subject more ably 
presented, it appears to me, than was done by Dr. Kinsman. I only 
regret that he did not go a step further and give us the results of the 
attempt that is being made by law to suppress tuberculosis among the 
cattle in the States of New York and Massachusetts. My impressions of 
this subject are derived mainly from reading agricultural papers Of 
course, there are many agricultural papers which lack information, and 
there are certain agricultural and other papers that are conducted 
upon a very high plane of intelligence, such as the American Agriculiur- 
ist, and the continuous reading of these newspapers has impressed me with 
the fact that in undertaking the prevention of tuberculosis among cattle, 
we should adhere to the old Roman maxim — go slow. When the law 
was passed in 1893 in New York, the people entered upon this subject 
with great zeal and enthusiasm, and committees were appointed to make 
investigations. It is apparent from some of the reports that where there 
has been great destruction of cattle, there have been no cases of consump- 
tion at all. I am as much in favor of the law as Dr. Kinsman could be, 



OHIO STATE BOARD OF HEALTH. 285 

and I hope that in cases where it is necessary to kill cattle on account of 
tuberculosis, the farmers, when settlement is made, will be allowed a fair 
price in cash for their stock. ins;e.id of hall price, as indicated in those 
states; thus obviating one ol the great objections that would be in the 
way of those undertaking this great re'orm. 

Prof. Nelson, of Delaware : We have left our homes and come to this 
place to listen to these papers. The question comes to my mind, what 
good are we to take to our sev< ral homes from these papers? Dr. Kinsman 
has very ably discussed the cause of tuberculosis. I suppose we will all 
agree that there issu^h a disease. We don't need any further light in 
that particular. He has showD us that the disease is due to the bacilli. 
I think we are all agreed there now. He has told us that the disease is 
communicated by the means of expectoration. We have agreed there, 
but how about the people in the several towns where we live — is it gener- 
ally known — is it believed by the people of these towns, by the school 
children, by the boys and men on the street, that the disease is communi- 
cated by the disgusting habit of spitting? We are a nation of the 
greatest spitters in the world. You may walk up and down the streets of 
Paris for hours without seeing a man, certainly not a woman, expectora- 
ting on the street. You cannot go through an American town, at least any 
that I have been in, without seeing it practiced every five minutes. Now, 
gentlemen, I don't believe that we have been educated yet up to the point 
where we can check tuberculosis. It is all right to talk about working 
with the cattle. Let us begin there if we cannot begin anywhere else, for 
we must be doing something. I think it is greatly a matter of education. 
I think the matter should be brought up in every public school. I think 
that, as health officers, we should see to it that the teachers of the public 
schools where we live should talk upon this subject, that the children may 
be enlightened and instructed as to where the danger lies in this direction. 
It seems to me there are two or three other things that we should empha- 
size at the same time. I think we ought to emphasize one thing that Dr. 
Kinsman says, that consumption is not hereditary. I find this, that 
statistics show in cases of consumption that nine per cent, of such cases 
are rated in families where there is no trace of the disease. You may 
explain that nine per cent, by the fact that the sputa has been discharged 
around the house carelessly, and children and grown people have come in 
contact with it in such a way as to produce consumption. I think 
another thing right along there should be done, and that is our people 
should be convinced and taught that consumption can be cured, certainly 
if taken early enough. In hospital experience we find a good many 
subjects where there has been tuberclosis and the tubercules have been 
destroyed where the disease has found lodgment, and the disease has been 



286 ANNUAL REPORT 

checked. And we all know of cases of people afflicted with tuberculosis 
who have gone west to Mexico and California, and have lived good sound 
lives after that. I am inclined to think we ought to have a health in- 
vestigation of our families that are tuberculized. It seems to me that the 
time ought to arrive when the family physician, if not the health board, 
should take it upon himself to visit families and say, here is a child and 
from its constitution it is liable to this disease, and should be separated 
from the other children. You ought to put special limits on such cases. 
Now put on your precautionary measures in regard to school life, in re- 
gard to habits of dress, and in regard to diet. I have been delighted to 
read that one of our health officers in the United State-", a physician in 
St. Louis, claims to have found a perfect cure. I am somewhat acquainted 
with the St Louis doctor, and he claims that he has discovered an anti- 
toxine that for consumption is as perfect as the anti-toxine for diphtheria. 
He has been working upon it for years. The same thing has been pre- 
pared in Paris and in Berlin. Of course it is too early to judge of this 
new remedy, but let us hope that success may come; there are two sides 
to this problem always. There is the iodividual side and the diseased 
side, and I think the individual side is more important. I want to build 
a house as nearly fireproof as possible within the limits of the means I 
have at my disposal. I want to give that house as good a chance as 
possible. At the same time I want the town where I live to have a good 
fire department. I want to build up just as good a constitution as I can 
for myself and all my friends, so that they will be prepared to withstand 
the disease. In addition to that, I want to stop the disease somewhere, 
so it will not come to my home or town. Two things are indispensable; 
we must begin at home, and we must begin with children. It must be a 
constant courfe of education. At the same time the doctors and health 
officers must do all they can to ward off the disease, to learn how to con- 
trol it after it comes, and to learn how to cure it. I believe, then, that 
two lines of work are open to each one of us as we prosecute these labors 
in the various towns where we live. 

Dr. Kinsman, have you faith in tuberculin as a diagnostic? 

Dr. Kinsman: I have. 

Prof. Nelson : Could not we introduce that into the practice in this 
State and thus ascertain to what extent our herds of cattle are afflicted? 

Dr. Kinsman: I believe it can be done. We are using that in cases 
of inoculation to decide cases of glanders. 

The Chair: The next subject for discussion is one proposed by the 
Board of Health of Weston : "Is the Dry Closet System to be Recom- 
mended for School Buildings?" the discussion to be opened by Dr. William 
T. Miller, member State Board of Health, Cleveland. 



OHIO STATE BOARD OF HEALTH. 287 

[Dr. Miller here discussed, without notes, the "dry closet'" and other 
systems of disposing of excreta. The stenographer failed to report his 
remarks, and it has been necessary to omit this part of the discussion. — 
Editor.] 

Dr. Clark, of Ashtabula : I have had the honor of bei^ig a member of 
the school board of our city since 1884, and within that time we haye 
built three buildings and introduced the dry closet system, and I must 
say that it has given entire satisfaction. I am not speaking on the sub- 
ject in a scientific way, but none of our teachers or pupils have ever 
complained of any smell about those buildings. We are entirely satisfied 
with that system. 

A Member : Dr. Miller neglected to tell you concerning the air that 
is carried over the fecal matter for the purpose of discarding it through 
the ventilating flues. Sometimes this foul air in being discarded comes 
down the flue into the school room. I know of a school where this system 
is used where this was the case. In two or three instances I have known 
of persons in school who were made sick by this foul air. The flues do 
not always carry the air upward. In some cases it is almost impossible 
to prevent this, and I think it is sufiicient to condemn any system of dry 
closets 

Mr. Schachleiter, of Ironton : That is exactly the case with the 
Kingsbury building at Ironton. There are about 800 scholars there, and 
more or le?s of them are aflected by this foul air in the building, and we 
are awaiting the result of this investigation to-day to see whether we can 
find out by the originator, or through some genius who is here, to tell us 
what to do with this system. 

Dr. Miller, of Massillon : This whole matter resolves itself into the 
question whether a practically reliable draft can be maintained in a chim- 
ney or stack, the chimney or stack being constructed on the best prin- 
ciples and in the best naanner known at the present time. The warming 
of houses, the running, of machinery by steam, all systems of natural 
ventilation (whether connected with the air closet or not) are based on 
the afiirmative answer which is given to this question by science as well 
as by experience. If facts justified a negative, the wheels of imperial 
industry would stop ; in fact would never have started. If reliable ven- 
tilation can be obtained by means of a draft in a warm chimney, the air 
moving toward the stack will not be turned back by the necessity of pas- 
sing over excreta. The air closet (or dry closet) is one of the methods by 
which we may hope to be able to safely dispose of human excreta. The 
safety of sewer connections and plumbing arrangements in our houses de- 
pends on the proper application of recognized scientific principles and the 
honesty and capability of the mechanic and the one who plans his work. 



288 ANNUAL REPORT 

Is the water carriage disposal of excreta to be indiscriminately condemned 
because a large percentage of the plumbing now in the houses is faulty in 
principle or botched in the construction? The safe and inoffensive dis- 
posal of excreta by burning within the building depends on a correct 
application of the same principle, to- wit: That ivarm air is lighter than co'd 
air. If this were not true, I suppose the earth would be uninhabitable. 
The same principle is invoked in successful and safe plumbing. 

School childrtn are probably the healthiest class in any community, 
and are not, probably, to an alarming extent, entertaining and throwing 
off disease germs. If they a7-e each a laboratory for the manufacture of 
germs, however, are n6t these germs as likely to be cist off from unclean 
bodies, covert-d and lin^d with extensive excretory surfaces, in the school 
rooms as in the closets? The percentage of absent sick iu buddings using 
the air closets and those using other systems would be interesting data for 
comparison, other conditions being as near equal as possible. I have 
observed this to a limited extent (personal observations are necessarily 
quite limited), and the comparison was not to the hurt of the air closet 
system. So far as known at present, I think, none of the three systems 
of disposal of excreta by earth, air or water, can claim to be practicably 
applicable in all cases. It becomes sanitarians to recommend such meth- 
ods of disposal of excreta as shall be most feasible and effective and least 
offensive and hurtful under specific circumstances ; when all this is done, 
the great question of the disposal of the waste products of civilization, 
without hurt or danger to health or life, will remain to confront the sani- 
tarian so long as civilization and its admirable product, the sanitarian, 
shall continue to exist. In the meantime important business interests 
ought not to be imperiled by unripe statements made here in the sup- 
posed interests of sanitation. 

A Member : We came here to get definite knowledge on these sub- 
jects, and if our State Secretary has some definite knowledge I think the 
convention would like to hear him. 

Dr. Probst : I can only give you definite information in regard to 
buildings I have inspected where the dry closet system is in use. There 
are, undoubtedly, times when this system does not work properly. I was 
called to Carey a few months ago on account of an outbreak of diphtheria 
that had occurred in one of their school rooms. When I talked to the 
members of the school board about investigating the ventilation of the 
building, they thought it would be entirely unnecessary because they had 
had the dry closet system in use for the past eight years, and it has given 
entire satisfaction. They had had numerous committees to examine the 
school building in regard to heat and ventilation, and they had always 
reported favorably regarding the operation of the system. It happened, 



OHIO STATE BOARD OF HEALTH. 289 

however, to be an exceedingly windy day when I was there. We went 
through the building — the board of education, and health officer, and my- 
self — testing the outlet and inlet registers in every room. 

In all of the rooms, in one-half of the building, those on the leeward 
side, we found currents of air coming into the room through the foul air 
registers. At the same time currents of air were passing out of the room 
through the fresh air registers. The direction of air currents was shown 
by using long strips of tissue paper. It was interesting to see those strips 
blown into the room or pulled tightly against the registers when there 
were changes in the direction of the currents of air. 

I have found these back currents of foul air in other school buildings 
where the dry closet system is in use. I have no knowledge of such con- 
ditions having been the cause of disease, but, on theoretical grounds, 
there is a possibilit}'^ that this may occur. . T^ phoid fever has been caused 
by the escape of sewer air into dwelling houses. In this case we must sup- 
pose that typhoid fever stools have been thrown into the sewer, and that 
the typhoid germs, having been liberated by drying of the stools, were 
carried by air currents into the house. If this be possible — and there is 
good authority for it — it is also possible for germs of disease to be carried 
into school rooms by currents of air passing through the dry closets in 
the wrong direction. 

Dr. Hopkins, of Ashtabula: I would like to ask Dr. Probst, then, 
why we use water closets if we get typhoid fever into our homes? I 
don't see but we may find fault and pick flaws with almost any system 
for the disposal of night soil. In my own city we have three of those 
systems in working order. If I thought they were a detriment to our 
people and children I should think we ought to get something better. 
The lact that we may get some smell Jrom them is true. That I concede; 
but we also can get that from our sewers. From all kinds of water closets 
we get smells, and we can condemn them on that ground if it is detri- 
mental to health. If we can say to our people, or to the inventor of the 
system, that we get the air contaminated a great deal more and a great 
deal oftener than we would in any other way, I think we should condemn 
it. If not, I don't believe in a wholesale condemnation of a thing that in 
the main works well. We feel as though we have been doing the best we 
could for our school children 

Dr. Hoover: I have about come to the conclusion that water closets 
should not be an integral part of a house, whether it be a public or private 
building, unless it is constructed in such a way that there can be no 
possible opportunity for unpleasant smells to arise which would find their 
way into the living part of the house, or part that is occupied. I believe 

19 ST. B. H. 



290 ANNUAL REPORT 

that will be the solution of this question eventually. We have had 
difiFerent systems here in Columbus for heating the public buildings, and 
in a majority of instances they are satisfactory, but in a few instances 
they have failed. Now, whether it is the difiference in construction, or 
whether they should all be alike, or what the difficulty is, it is hard to 
solve. In our Central High school here one of the systems is a failure, I 
am satisfied, because of ignorance in its management. And in one or 
two of the new buildings that we have constructed the systems have 
proven satisfactory, have had no trouble and no fault to find with their 
operation. I think, myself, the proper thing to do is to separate the 
closets from the building in such a way that it is utterly impossible that 
there should be anything obnoxious or dangerous to the building. 

Dr. Miller, of Cleveland: I will say that fecal matter should be 
sterilized. You can do that by hot water or fire, but you can never do it 
by air at a temperature of sixty-five degrees. I don't care whether it goes 
out in the stack or back in the room. It contains the germs of disease. 



THIRD SESSION. 



Thursday, 7:30 p. m., January 24, 1895. 

The Chair: Gentlemen, the first thing on the program is a paper 
on the subject, ''The Disposal of Night Soil and Garbage at Warren," by 
Mr. William T. Fee, Mayor, and President of the Board of Health of 
Warren, 0.: 

THE DISPOSAL OF NIGHT SOIL AND GARBAGE AT WARREN. 

By Mr. William T. Fee, Mayor and President of the Board of Health of Warren, O. 

Mr. President, Members of the State Board op Health and Gentlemen: 
Your worthy Secretary has invited me to explain what disposition our city of Warren 
makes of her "night soil." 

This has become a very serious problem, especially in cities of about or under ten 
thousand inhabitants. By hauling it to the "dump grounds" it soon accumulates and 
becomes a nuisance. Its disposition by chemicals or incineration in a crematory is, by 
reason of its expense, impracticable for the municipal economy of a community of our 
size. And, besides, it would then thereby be reduced to a worthless waste and lost as a 
fertilizer. 

Being somewhat interested in this sanitary question, and we having given the sub- 
ject some consideration, permit me to give, somewhat in detail, our "modus operandi," 
that a more intelligent understanding may be had of our solution of this problem. 

Our board of health has prohibited the construction of any water closet without a per- 
mitfrom the board, and that they shall conform toone of three kind<;, namely : First, those 



OHIO STATE BOARD OF HEALTH, 29 I 

connected with the public sewer; second, water-tight vaults built cf stone or brick and 
cement, with an extension back, covered with a flag stone, so as to permit of emptying 
without disturbing the building or injuring the walls; third, water-tight drawers or re- 
ceptacles in which daily use of dry earth, ashes, or air-slacked lime is required. The 
last two kinds of closets require frequent cleaning — the drawer system more often than 
the vaults. 

We have a night soil contractor, employed by the year, to empty all vaults at a cost 
of nine cents per cubic foot, and ordinary sized drawers for one dollar each. This work 
is done mostly in the night time or very early morning. 

The owner of a closet desiring the same cleaned, applies to the sanitary office, 
wher<», in a book for that purpose, is kept a record of the drawers and dimensions of all 
vaults in the city. The sanitary policeman gives the owner a check or slip from a stub- 
book of blanks, whereon is stated the name, street and number, the amount in vault or 
drawer, as the case may be, and the amount of money to be paid. The holder takes this 
check or slip to the bank, pays the amount required, the bank stamps the slip ''paid," 
and drops it in a board of health metalic safety-box, with Yale lock — similar to govern- 
ment letter-box, only smaller — fastened in the bank or some convenient place. The con- 
tractor, who has a key to this box, goes to it and gets the slip. This slip indicates to him 
his order for work, and place where, and also the important fact that the cost of said 
work is deposited in the bank. At the end of each month the Pres'dent of the Board of 
Health gives the contractor, in exchange for the month's slips, a check on said bank for 
the amount. The contractor has a large platform wagon, furnished by the board, upon 
which he carries the night soil, in well made, stroflg, oak barrels, with water-tight covers, 
fitted in rubber gaskets. 

We have a dump-ground owned by the city, and under the control of the board, 
situated on the low lands that drain from and just outside of the city limits, containing 
about fifteen acres of land, to which the night soil is taken by the contractor. At the 
dump-ground cur board had constructed two rectangular reservoirs or pits of earth. 
These rfservoirs are 20 x 40 feet in dimensions, and made parallel to each other, with 
space enough between for a passigeway. They are about three and one-half feet deep, 
side and end walls slanting, and made of the earth Irom the pits. Drain-tile are placed 
below the surface of the bottom, at a siifficient grade to carry off the surplus urine and 
water. 

A narrow, long platform is built from the end of the pit, extending over the wall 
and down the center, for the purpose of aiding the unloading and dumping of the con- 
tents of the barrels from the wagon. Over each pit or reservoir is erected a board roof 
shed, gable ends, with sides boarded down far enough to give strength to the structure 
and prevent rain and snow from blowing in, and yet leaving open space sufficient to per- 
mit easy access to the pits and the passage of an abundance of air. These structures 
have been made of cheap, rough material, and been given a heavy coat of iron paint and 
oil. The total cost of the two structures, together with the pits, is about $250. The 
contractors are required to use air-slacked lime, or better, dry, pulverized earth, or both, 
on the night soil as soon as dumped. This serves the purpose of taking up the moisture, 
holding the gases and ammonia, and decomposing the night soil. By the time the sec- 
ond pit is nearly filled, the first pit, if properly drained of surplus water, and lime and 
loam has been liberally used, is composted and becomes a valuable fertilizer. The com- 
post sells readily in the pits to farmers and gardeners at twenty-five cents per cubic yard. 
When the utility of this product becomes better known we expect to obtain better prices, 
as one of our farmer friends, who was first to use it, now wishes to contract for the entire 
product of the future. Those who have used it commend it for its lastinsr quality and 
great strength as a fertilizer. To obtain best results from its use it should be thinly 
spread over land and thoroughly mixed with the soil. Pulver zed dry earth will com- 
pletely decompose fecal matter, and without cffense. This property of mother earth, by 
which dead organic matter is converted into inorganic matter, has long been known. 



292 ANNUAL REPORT 

Besearch has shown that it is due to the germ life or the myriads of microbes which 
live in the soil and feed upon such matter. This germ life abounds almost exclusively 
in the upper layers of the soil. For this reason when a large amount of fecal "matter is 
placed in a deep hole in the ground it is then below the level of germ action, where 
much of it remains a constant source of danger. 

In our dry earth closets ashes are often used; but they do not contain the germ life 
which produces decomposition of organic matter, their action being simply mechanical — 
absorbing the moisture — not vital, as is the case with rich, loamy soil. Fecal matter 
deposited in the upper layers of the soil, or thoroughly mixed with it, is quickly decom- 
posed and converted into food for plant life. 

If the night soil is composted in the pits, and when removed well mixed with the 
soil and used on lands that drain from source of water supply, it seems there is little if 
any danger in point of health, or at least not more than would be from the use of many 
of the commercial fertilizers now on the market. 

In this simple, systematic and inexpensive way we defecate our ciiy, materially 
reduced our death rate, and making typhoid fever almost unknown in our midst, save 
and return to the soil a valuable fertilizeJ, receiving from which a considerable money 
return for what would otherwise be considered a waste and a nuisance. 

We do not claim perfection for our system, but believe we have taken a long stride 
in advance of the poisonous pit of fecal putrefaction that is a dangerous source of con- 
tamination and constant menace to the health of any community. 

The Chair : Gentlemen, this brings before us for discussion, the sub- 
ject of disposal of night soil and garbage. We will be glad to hear from 
you upon the subject. 

Dr. Probst: I simply want to thank Mr. Fee for presenting this 
paper on the disposal of night soil and garbage, and I can endorse it for 
even more than is claimed for it. The town is in perfect sanitary condi- 
tion. They take care of their night soil in a way that any town of that 
size might do, and I think that we have bad a most profitable paper read 
to us on that subject. 

The Chair: Gentlemen, inasmuch as the next subject is similar in 
character to the one just discussed, how would it do to go on with the 
next subject? If you deem it advisable, I will call on Mr. W. B. Gerrish, 
city engineer of Oberlin, Ohio. 

A Member: Mr. President, I move that that be done. I think it 
will save time and be profitable also, as the subjects are closely related to 
one another. (Motion seconded and carried.) 

SEWAGE PURIFICATION AT OBERLIN. 
By W. B. Gerrish, City Engineer, Oberlin. 

Mr. President and Gentlemen: After the water works were built in Oberlin, 
in 1887, the people were constantly reminded that a sewerage system was a necessity. 
The question would arise: What shall we do with our sewage? There was no stream 
of water near the town. The only possible outlet was Plum creek, a stream which was 
dry during the summer months. If the sewage were turned into this stream it would 
become an elongated cesnpool ; a menace to the health of the farmers along its course, as 
well as a serious contamination of the water supply of Elyria, since that village draws 



OHIO STATE BOARD OF HEALTH. 293 

its supply from Black river, below the mouth of Plum creek. It was evident to all that 
if Oberlin was to have sewers it must purify its sewage. In the construction of its 
sewers the separate system was adopted, namely: No storm water is admitted to the 
sewers, and only the household waste is conveyed by them. Consequently we have 
nothing to purify except actual sewage, and the amount of this, of course, is not large. 

Twenty acres of land were purchased a mile and a half from town, and a trunk 
sewer was given as small a grade as was safe, so as to deliver the sewage upon a farm 
as high as possible. We were able, however, to reach a point only ten feet above the 
bottom of the creek, with five acres of land below the grade of the sewer. The balance 
of the land was very much above this elevation. We studied all we could find on eewage 
purification by irrigation, but the cost as the irrigation fields were usually prepared, 
rather appalled us, so we began experimenting to see if we could not accomplish the 
desired results at less cost. The first thing done was to dig a small pit in the earth, and 
we were surprised to see how much of the solid matter was removed from the sewage by 
mere sedimentation. After pasi^ing through the pit the sewage was allowed to pass 
over tbe ground among the grass roots — the field was formerly a meadow — and the sew- 
age was rendered very clear, about 70 per cent, of the total organic matter having been 
removed. 

If a small pit and running the sewage through the grass would'accomplish so much, 
surely allowing it to pass through the ground would accomplish much more. We then 
set about preparing the field, as shown on the blackboard, which I will explain later. 
Pits were dug four feet by twenty-five feet by three feet deep, and two and a half acres 
on the west side of the drive were underdrained by two and a half inch and four inch 
tile, three or four feet deep and twenty feet apart. This land has been divided into 
twelve areas by small ridges. A system of carrier ditches conveys the sewage to the 
different areas where the sewage enters distributing ditches; by overflowing the tops of 
these the sewage is spread upon the area. It then seeps through the soil to the drainage 
tile and thence flows to the creek. The areas on the upper part of tbe tract are larger 
because the soil is largely clay, while 00 the lower ground it is a sandy loam. 

Colonel Waring, in his new work on "Modern Methods of Sewage Disposal," calls 
particular attention to the necessity of puddling the back filling in the trenches where 
the drainage tile have been laid. The book, however, was not published until after we 
had learned this fact by experience. Without puddling the trench the sewage will form 
rills through the soft earth and find its way to the tile without purification. 

The land is seeded to alfala, Italian rye grass and common red clover. Thus far 
the Italian rye grass appears to be the best crop to seed witb. Whatever the farm will 
produce is accepted with thanks, but the crops are placed secondary. The farm is in- 
tended for sewage disposal, and everything is made to bend to that end. The land on 
the east of the drive is used when cleaning the sludge pit on the west side. A little 
tiling has been laid here to drain a few low spots where the sewage was likely to settle 
and sour. The sewage is conveyed to different parts of this land by carrier ditches hav- 
ing a slight fall. Then by placing small dams at different points the land below is over- 
flowed. No masonry was used on the work, the pit has no lining and neither have the 
ditches, and for many reasons they are much better with their earth sides. The total 
cost of preparing the land, tool house and necessary equipment was a little over $500.00. 

The care of the farm consists in changing the flow each day from one area to 
another, and about once in a week or ten days tbe accumulated sludge in the pits is 
pumped into a tank on a wagon and hauled on the high ground, where it gives most 
astonishing growth to the grass. The grass and weeds around the bed are kept well 
trimmed and many little things done to give the farm a neat and tidy appearance. 
During the summer season a man was employed practically all the time at $7.50 per 
week. As before stated, a great deal of his time was occupied in improving the farm. 
Between 300 and 400 trees have been set out, and it is proposed to make it an attractive 
place. During the winter the man who changes the flow receives $3.00 per week. A 
team is hired one-half day when we clean sludge for $1.50. The farm has now been in 



2 94 ANNUAL REPORT 

operation during both cold and hot weather and the residents in the neighborhood are 
satisfied with the way it is conducted. There is no order about the farm except directly 
over the sewage as it is spreading ought and right around the pit when cleaning sludge- 
It might be supposed that in the winter the frost would cause trouble, but you will re- 
member that sewage is always warm. We never found it at Oberlin below 44 degrees 
Fahrenheit, and it will melt its way under the snow, leaving a crust of snow and ice sup- 
ported on the tufts of grass, while the sewage will percolate through the soil as in the 
summer. A sewage farm will not care for itself, but requires intelligent oversight. 
The amount of work to be done at any one time in caring for the sewage is small, but 
that little must be done just at the time it is needed. The results, however, amply repay 
all the trouble, and the village is enabled to enjoy the advantages of a sewerage system 
without injury or detriment to its neighbors. 

[The speaker then explained the methods of operation at the Oberlin 
sewage disposal plant, using the blackboard for the purpose of illustra- 
tion.] 

The Chair: Gentlemen, this brings before us the disposal of night 
soil and garbage and also the purification of sewage, which we will be 
glad to have discussed now. Have you any remarks? 

Mr. Hartzell, of Canton : The subject of the pollution of streams, 
or rather of the pr:;vention of the pollution of streams, is one that has 
always interested me greatly, and I have waited, and watched, and hoped 
these many years to read the details of a successful experiment such as we 
have heard this evening. My interest in this has been considerably 
stimulated by the fact that in Canton, where I live, we were compelled, 
before we built sewers, to provide for the disposal of the sewage. We were 
not allowed to do any taxing, or raise any money, until we had arranged 
to dispose of the sewage in a manner satisfactory to the farmers living 
below Canton. While we adopted a different system — a system of puri- 
fication by a chemical process — it is apparent and is proven by this ex- 
periment that this is a cheaper plan, where it can be employed, and better 
adapted to a great many small places in need of sewage purification. 

The engineer of Oberlin has shown us that this thing can be done. 
He has shown us how it can be done, and the result of doing it. And 
the paper by Mr. Fee, of Warren, shows us why it is that the sewage is 
purified by the upper layers of the soil. But because this is true, it must 
not be inferred that it is adapted to all towns, because there may bs great 
differences. That is to say, suppose a commission was appointed that 
had full control over the cities in the State, and suppose that commission 
would say : Oberlin disposes of her sewage in this way, therefore this, 
that, and every other town, and any town coming under the supervision 
of it, must do it exactly in the same way. That would be an impos- 
sibility, because this is a very variable science, or application of science — 
the disposal of sewage. It is an art which calls to its help engineering 
and chemistry, and is really the application of science to the solution of 



OHIO STATE BOARD OF HEALTH. 2:5 

a great sanitary problem, and a great many things have to be taken into 
consideration. There is a difference in the outputs of towns. For in- 
stance, Oberlin has 40,000 or 50,000 per day, while Canton has a million 
gallons a day. One town may be on the lake and one on the Ohio river, 
on the border of the State where there is a divided control. One town 
maj' be situated so that the sewage reaches the field where it is to be 
drained, by gravity, and in another case it has to be pumped. There is, 
also, a financial problem ; I found these things were to be considered 
when we were compelled to adopt some system for Canton. We had to 
grope in darkness, so far as our country was concerned, there being only 
one place where sewage was treated, viz., at Pullman, Illinois. But now 
there are many such disposal systems. I visited one at Farmington, near 
Boston, where the conditions are almost the same as at Oberlin, and there 
was no trouble from freezing, the warmer sewage running under the snow 
and ice, and undergoing purification as well as in summer. In Rhode 
Island I saw one place where sewage is disposed of by broad irrigation ; 
in another place by intermittent filtration. All the sewage of Berlin, and 
nearly half the sewage of Paris is so treated — 14,000 acres are used in that 
way. At Pullman, Illinois, the same experiment was tried, and a great 
deal was said about it years ago, but it has been abandoned for the last 
three or four years. At Worcester, Massachusetts, they undertook some- 
thing of the same kind, but they now dispose of the sewage by chemical 
precipitation, as at Canton, in this State. So far as American experience 
goes, it would seem that places having, approximately, over about 500,000 
gallons a day, have preferred to dispose of the same by chemical precipita- 
tion, that being better adapted to large quantities of sewage, whereas in 
smaller places they dispose of it as they do at Oberlin. In Canton we 
adopted chemical precipitation, and I believe, at any rate I hope, that 
inside of five years steps will be taken in many towns in the State of Ohio 
to introduce either one of these, or some other plan that will save our 
inland streams from pollution. The construction of water works and 
sewers has assumed large proportions. If these laudable enterprises are 
not supplemented by purification, there is danger that our natural streams 
will be converted into open sewers, especially in periods of low water. 
This is an important matter, and should be well weighed by every town 
which creates a sewage effluent ; and viewed in this light the facts that 
have just been placed before us by Mr. Gerrish, demonstrating the success 
of the Oberlin experiment, should have a wide and careful hearing. 

Dr. Bridinger, of Tiflin : I have sat here and listened to the matter 
of disposing of sewage. Of course all cities have a way to dispose of their 
sewage. Now then the thing occurred to me was, what is a city going to 
do when it cannot run sewage up hill? You cannot make water or 



296 ANNUAL REPORT 

sewage run up hill. What are you going to do when a city is so con- 
structed that you have to run the sewage into a stream, or else probably 
eight or ten miles in a stream before it could get on the farm ? It would 
make it rather expensive to do that. I suppose there are some cities that 
are situated that way. Mansfield, for instance, can run sewage on a farm 
close by with little expense in the way proposed here. The way we are 
situated at Tiffin is, we have hills all around us, so that the sewage would 
have to go up hill in order to get on the farm, and consequently we have 
no place to put it except in the river. That is the difficulty there, and I 
would like to get some information with regard to the disposal of our 
sewage. During the winter time, and when there is plenty of water in 
the river, we have no trouble at all, and no complaint from the farmers 
below the city. We have thirty- five miles of sewers; our city is com- 
pletely sewered. We flush out our sewers every two weeks, and rush 
everything in the river. Here is our difficulty. In the summer time, 
during the months of July and August especially, the river gets very low. 
We have our water works right above the city, and they hold the water 
back for the purpose of water power, and consequently in the daytime 
the water don't run down, and it gets so low that you can hardly float a 
newspaper. When it gets low it becomes very obnoxious and ofiensive, 
and people want to know what to do with it. I suggested a dam to be 
built of sufficient height to back up the water. Some proposed a channel, 
which would be very expensive, as the bottom is solid rock, and others 
claimed that the dam would fill up and would require great expense to 
build it. 

Mr. Ghaster, of Fostoria : We find that we have reversed the Canton 
system of sewerage, or their modus operandi. In other words, we have 
built our sewerage system and now we want to dispose of our sewage. 
We have a small stream in which our sewage empties. We pump from 
a half to three-quarters of a million gallons of water per day. The mouth 
of the sewer is on a level, or, possibly, a few inches lower than the stream, 
and I would like to know how we could dispose of the sewage. The 
mouth of the sewer is below the city, and we don't feel that we are treat- 
ing our farmer friends right below town to force this sewage upon them, 
as we have done for a year or more. We had members of the State Board 
of Health to visit us and examine into the matter, and plans were made 
lay the city engineer which were elaborate. I believe the Secretary of the 
State Board of Health would bear us out in that; but nothing has been 
accomplished. Our board of health is solicitous that something should 
be done, and I would like to know the best system of disposing of this 
sewage. We are in a level country as well as our friend from Tiffin, who 
is a neighbor, and we are at a loss how to dispose of it. 



OHIO STATE BOARD OF HEALTH. 297 

Mr. Wickham, of Findlay : I am not the health officer from our 
city, but I see him here, and I guess he is too bashful to say anything. 
We have a system of sewage disposal that we are quite proud of. Our 
city, on the north side, is quite well sewered. This sewer empties down 
below the main part of the city. The south one empties close to the 
business part of the town, right in the main street. That is a nuisance ; 
but to a certain extent we obviate this nuisance by not permitting water 
closets to be connected with the sewer. There may be a lew that are, but 
it is the intention of the board of health to keep the water closets oQ of the 
sewer. Our night soil is gathered by scavengers and hauled to the 
crematory, at which place it is disposed of. All matter of that sort is 
hauled to the crematory and destroyed. All dead horses, cows, dogs and 
everything of that kind are taken to this crematory and destroyed. I hold 
here in my hand the report of 1892, which shows that in 1892 there were 
4,089 cubic yards of common garbage burned, 5,541 barrels of night soil, 
eighty-five dead horses, 154 dead dogs, sixteen dead cows and four hogs 
were cremated. Nothing of the kind is permitted to lay upon the streets 
or permitted to be thrown out on the streets, but everything must be 
taken to this crematory and burned. Since we have had this crematory 
we have considerably reduced our death rate. I simply make this state- 
ment, gentlemen, to tell you what we are doing. 

Dr. Whitmar, of Millersburg: A question in regard to this system of 
sewerage at Oberlin. It is said that the sewage is spread over a number 
of acres of ground; I would like to know whether that soil might not be- 
come saturated in that way, and how long it might last? It looks to me 
that by emptying a large amount of sewage on to flat ground, it would 
finally become saturated and become a sort of cesspool. If such would be 
the case it would be rather a serious matter, but I am satisfied that the sys- 
tem is a very good one and well adapted to a great many of our inland 
towns of the State, providing that will not become a stagnant pool in the 
course cf time. If some of our chemists will show us that the vegetation 
will destroy that condition, we would probably be satisfied that it might 
be done for many years. 

Mr. Gerrish, of Oberlin : You remember my saying that when the 
sewage goes down the water flows ofl" in the drain-tile, and the air will 
follow it. The earth will then be full of air; of course, such a thing is 
possible as running on too much, but we don't depend on the vegetable 
or plant life to decompose the organic matter. It would take too long to 
go into details, however, about that. 

Mr. Hartzell, of Canton : It is a hopeful sign when people are inquir- 
ing what they shall do to be saved in diflerent parts of the State. Mr. 
Gerrish could tell you how it is done, but he is too modest. Get a first- 



298 ANNUAL REPORT 

clas3 engineer, if you have problems of this sort to solve— get a good one, 
[Laughter.] 

The Chair : We will pass to the next subject, namely : "Report of 
the Diphtheria Epidemic at Ashtabula," by Dr. William T. Miller, mem- 
ber State Board of Health, Cleveland. 



DIPHTHERIA EPIDEMIC AT ASHTABULA. 

By Dr. William T. Miller, Member State Board of Health, Cleveland. 

Mr. President and Gentlemen: On December 13, 1894, 1 received a telegram 
from Dr. Stanton, our President, notifying me of an epidemic of diphtheria at Ashta- 
bula, and requesting me to visit that place immediately. I was tolerably familiar with 
the situation from a former experience with the same disease, which occurred there two 
years ago in an epidemic form, and also from the daily press reports, which indicated a 
grave situation. Appreciating the gravity of the condition, I procured the assistance of 
an expert in bacteriology. Professor William T. Howard, late associate and collaborator 
of Professor William Welch, of Johns Hopkins University, whose work in this special 
line received universal commendation at the Eighth International Congress of Hygiene, 
held at Buda Pesth last year. 

Upon our arrival we met Mayor McKinnon, the board of health and the health offi- 
cer. Dr. Hopkins. The conditions, as found, were as follows : 

The disease had been somewhat prevalent throughout the year, in the first and sixth 
wards especially, thirty cases occurring, an average of two and eight-elevenths cases per 
month in the latter ; fifty-seven cases, an average of five and two-elevenths per month in 
the former. These two wards constitute the harbor, separated from the main portion of 
the city by a distance of several miles, and populated by the ore handlers largely, whose 
habit of living favors the extension of contagious diseases. The cases reported for eleven 
months prior to December 1, in the d fferent wards were as follows: In the third ward, 
four cases; in the fourth ward, eleven cases, and in the fifth ward, one case. From 
December 6 to the 9th, to the date of our arrival, on the 13th, inclusive, there had 
been reported in the second, third and fourth wards, fifty-six cases in forty-eight houses. 
This alarming condition had caused wide-spread fear among the people, and unusual 
activity on the part of the local authorities. 

From a study of the situation, the board of health and Dr. Hopkins, the efficient 
health officer, decided that there must be a common source of infection, and that it was 
the milk supply to the infected famil'es. Acting upon this opinion they ordered the 
discontinuance of the sale of milk for fifteen days, pending further examination. The 
history of the onset undoubtedly pointed to a common source of infection, fifly-six cases 
occurring in peop'e of all ages, not intimately related by social or family ties or prox- 
imity of dwellings. The problem, as it was presented to my mind, was capable of study 
from several standpoints. First, the food and water supply. Second, the rapid exten- 
sion of the disease by means of schools or public gatherings. The consideration of the 
first proposition immediately established the fact that the primary cases were all customers 
of one milk farm. The water supply of the infected families was from wells and the 
water works. 

The question was next examined from the standpoint of extending by means of the 
public schools. An examination of the records demonstrated the fallacy of this position, 
for although it is conceded by the authorities that children are more prone to the disease, 



OHIO STATE BOARD OF HEALTH. 299 

the opposite condition obtained in this instance. The first three cases reported in each 
ward were as follows : 

Second Ward. Third Ward. Fourth Ward. Fifth Ward. 

20 years. 13 years. 12 years. 25 years. 

30 " 30 " 3 " 4 " 

2 " 16 " 13 " 25 " 

Giving an average of twenty-one years. Although this disposes of the idea of origi- 
nating in the schools, I found several cases that could be traced to school companions 
eating an apple with a little girl who at the time complained of sore throat, and was 
afterwards treated for diphtheria. 

The consideration of the different church and Sabbath school gatherings was non- 
productive, the people being of a variety of faiths and religious habits. There were two 
gatherings of people by means of which the disease might have been communicated, but 
the authorities on this subject very much doubt if the disease can be transmitted by the 
air of the room. Grimm, a notion dealer, drew large crowds of people to his display of 
Christmas toys, by giving each child a present. The people also attended en masse an 
entertainment known as the Swiss Village, but it is doubtful whether such an extensive 
contagion could be propagated by means of the atmosphere. The clinical evidence was 
all in favor of the extension of the disease by means of contaminated milk. 

The history of the Henry Smith (the milkman) case, is as follows, as given by Dr. 
Hopkins. He felt ill on December 1, with pains in the throat, neck and limbs, with 
difficulty in swallowing, but did not consult a physician other than to obtain a sidewalk 
prescription from a doctor for quinine and whisky. He sold milk on December 2, 3, 
4 and 5 ; on the 6th and 7th he felt indisposed and remained at home, but not in the 
house. On the 8th he resumed his route again, and on the 9th, by an order from the 
health board, he was removed from his wagon, being replaced by another man who sold 
the milk on the 9th, 10th and 11th, when the health board ordered the sale discontinued 
for fifteen days. The milk was sold from ten-gallon cans, and long-handled dippers were 
used for measuring. The cases all occurred on Smith's route, although there were four 
other men selling milk in the same ward, no diphtheria having occurred on any route 
other than Smith's. A thorough investigation of the Smith farm was made by Professor 
Howard, Dr. Hopkins and myself. The cqws were well housed and fed, and in excellent 
condition, as shown by examination of nose, tongue, throat and joints. Everything evi- 
denced great care and cleanliness in and about the dairy ; the cans, buckets, pans, etc., 
being exceptionally clean, as were also the house and people. Professor Howard made 
cultures from the nose and throat of Henry Smith, noses and throats of the cows, cans, 
bell and handle, cash box, tickets, milk, butter and water. Cultures were also made 
from the throats of two patients. 

At a meeting of the board of health in the evening. Dr. Hopkins reported that the 
board had closed the schools and churches, and placed a rigid quarantine against the 
infected houses, preventing any one from leaving the house without a permit from the 
health officer ; had ordered that no mail should be received from the infected houses, and 
had given explicit orders as to the sanitary care of the patients with reference to isola- 
tion and clothing. The board, at the solicitation of many citizens, ordered a stock of 
anti-toxine, and Professor Howard kindly offered to superintend its use. He reports 
very favorably, and will be pleased to give the results in detail to the State Board. He 
also oflered to make cultures from the throats of the new cases, and also the cases before 
their discharge from quarantine. This offer was accepted, and no case was discharged 
from quarantine until bacteriological examination showed that there were no Lceffler's 
bacilli present. Professor Howard's report of the examination of the various cultures 
made at the Smith farm was negative, there being no L<pffler bacilli present. Large 
colonies were present, however, in the two cultures obtained from the diphtheria patients. 



300 ANNUAL REPORT 

The examination of Henrj Smith's nose occurred thirteen days after the disease was 
manifest. 

Receiving notice on December 20, that the towns of Warren, Kingsville, North 
Sheffield, Andover, Jefferson, Perry, Conneaut and Geneva had declared quarantine 
against Ashtabula, I called a conference of the health officers of these towns to meet at 
Ashtabula on the 22d, to consider the situation. Drs. Merriam, of Conneaut, and Tib- 
bets, of Geneva, were present. The situations were discussed, showing the thoroughness 
of the quarantine, and the limitation of the disease to the primary centers of infection. 
It was the opinion of those present that the situation did not warrant the declaration of 
quarantine. Letters were sent to the health officers, with a request that the quarantine 
be removed. The request was cheerfully complied with, with the exception of Warren. 

The number of cases occurring in the second, third, fourth and fifth wards, the epi- 
demic area, during the month of December, was as follows : 

Number of cases in males 48 

" " females 51 

" " sex not given 1 

Total number of cases 100 

Number quarantines December, 1894, 51. 

Deaths — Adults, males, 2; Females 3; Total 5 

Children, " 13; " 4; ' " ., 17 

'' One baby, sex not obtained 1 

Total deaths 23 

Number of deaths, males 15 Number of cases, males.. 48 

" " females 7 " " females 51 

Babe, sex not obtained 1 

Total deaths 22 

Total number of cases 100 

Total number cases over 21 years of age 32 Deaths 5 

" '' 18 years to 21 years 12 " 2 

" " 15 " 18 " 11 " 2 

" " 12 " 15 " 7 " 2 

" " 10 " 12 " 6 " none. 

6 " 10 " * 14 " 7 

" " over 1 and under 6 years 17 " 4 

" " under 1 year 1 " 1 

Totals 100 23 

Death in males 31 1-4 per cent. 

" females 13 7-10 " 

The total number of cases for the year was 216 ; deaths 41, quarantines 119. The 
same ratio of cases and deaths, according to population, would be: Columbus, 2,160 
cases, deaths 410; Cincinnati, 8,000 case8,deaths 1,517; Cleveland, 6,480 cases, deaths 
1,230. This accounts for the great business depression, estimated by a conservative busi- 
ness man as a shrinkage of $225,000 in the general volume of business of the year. 

The question as to the cause of the epidemic is yet an open one, although the clinical 
evidence is against the Smith milk ; the positive evidence, the presence of a specific germ, 
could not at that late day be determined. Kline claimed at Buda Pesth that when cows 
were inoculated with Loefler bacillus, the milk would contain the germ. Abbott, in 
experiments made a year later, disproves the claim. There is no authority for opinion 
that milk from the cows contains the germ, but of course milk would form a rich culture 
medium for genus accidentally added, and such milk would prove a fertile source of in- 



OHIO STATE BOARD OF HEALTH. 30I 

fection. It is believed that Henry Smith had the diphtheria, infected the milk, and 
caused the almost simultaneous appearance of the disease in forty-eight different houses. 

With reference to duration of quarantine, I think the examination of Dr. Biggs, 
which shows the variable length of time before the disappearance of the germ, demon- 
strates that no person should be dismissed from quarantine until the bacteriological 
examination of the throat and nose shows the part free from germs. I would recommend 
to the State Board the establishment of a number of distinct stations where bacteriological 
examinations of diseased conditions could be made. This would not only make a diag- 
nosis positive, but also quarantine effective. I would also recommend the change of the 
section providing for the declaration of quarantine by oue town against another, which 
should read as follows : 

" That the local board of health may, with the advice and consent of a representa- 
tive of the State Board of Health, order and declare," etc. 

Although the epidemic is over, the fact that there are always cases of diphtheria in 
Ashtabula is a constant menace to the health of the community, and all the energy and 
wisdom of her very efficient mayor, health board and health officer should be directed to 
stamping out every vestige of the disease. This can only be accomplished by the author- 
ities assuming ch>irge of the infected premises, cleansing, boiling or burning everything 
that has been in the infected room. 

Dr. Hopking, of Ashtabula : In the investigation of the recent epi- 
demic of diphtheria in our city, which has been very nicely stated hj Dr. 
Miller, we found matters just as stated by him. These one hundred cases 
reported to us received their infection primarily from the milk, or from 
others in the home. We found, also, that all the quarantines that were 
put up for these one hundred cases should have been put up as soon as 
the 10th of the month. I don't mean to say that we neglected doing our 
duty, but we found afterwards that we would get cases as late as the 12th 
and 13th, possibly the 15th, of the month, in new homes. I questioned 
them to find out whether persons in these quarantined houses had been 
visiting other homes, and from the bacteriological examination I found 
what had been called sore throat at the first, and should have been quar- 
antined, ultimately resulting in diphtheria. In two or three instances 
we found that mothers who had been in the habit of drinking this milk 
had sore throats at first, but thought it was just simply sore throat, and 
were running about the house and doing their work, and did not have a 
physician at all ; bat when we went there and examined their throats we 
found the bacilli there, and we were satisfied they had the disease. It has 
been very interesting to one who can look back upon it now. It was not 
interesting, however, at the time, I assure you, because it was too much 
of a serious matter to me. One mother had a grown up daughter sixteen 
or seventeen years old. She had a husband who did not like milk. She 
did, and had all she wanted. She was one of the first cases Dr. Howard 
examined. We found her throat to be in a very serious condition. Now, 
we got no anti-toxine until we had been up there ten days or two weeks, 
so that none of these cases were treated with anti-toxine ; but speaking of 
another case where a father and two children were fond of milk and were 



302 ANNUAL REPORT 

fond of bread and milk. He left for New York State, but got a telegram 
saying bis two boys were down sick witb diphtberia, and when be reacbed 
borne be also complained of sore tbroat, and bad tbe dipbtberia. Tbe 
motber and ber motber drank no milk, and altbougb tbey were exposed 
to the disease, did not catch it. I can mention other cases where persons 
no doubt contracted the disease from this milk. There is no doubt in 
our minds that this man's milk was at tbe bottom of the whole trouble. 

I want to say that Professor Howard is here with us. He aided us 
materially in this epidemic of diphtheria, and I want to thank him most 
heartily myself for his aid, I believe he has got something here to-night 
that would interest you and be a benefit to you. I asked him as a favor 
to come, because our board of health bad delegated me to see to the hand- 
ling of it — tbe use of anti-toxine, which I asked him as a favor to super- 
intend, and I call upon Professor Howard to talk to you awhile. 

Professor Howard, of Cleveland : Mr. President and Gentlemen : I 
hardly expected to be called on to do anything this evening, but I will 
be glad to relate to you my experience at Ashtabula if you think it will 
be of value to others. It was a matter in which I was very much inter- 
ested. As Dr. Miller told you, I went there on December 13, on bis invi- 
tation, to investigate the epidemic purely as a matter of interest. After I 
got there I became actively engaged in tbe work and spent tfiree weeks of 
my time there. 

Now, as to tbe spread of diphtheria in this case, there is little doubt 
in my mind that Henry Smith, the milk peddler, infected his milk and 
was the cause of the whole epidemic, and tbe way that he probably did it 
is also very interesting to you as health officers. There is no escape from 
a clinical study of the epidemic Jrom the fact that Henry Smith infected 
this milk. Although careful bacteriological examinations failed to show 
bacilli in bis throat or nose that does not at all detract from the probability 
that diphtheria bacilli had been present. The only thing that keeps it 
from being a certainty is that we failed to find tbe bacilli. It is well- 
known to those who study and make cultures from cases of diphtheria 
that tbe dipbtberia bacillus often disappears from the throat in a very 
few days. On tbe other band, in other cases it remains quite a number 
of days, and in one case that I know of, seven weeks after tbe disappear- 
ance of tbe false membrane. In most of the cities and towns in Ohio, I 
am informed, tbe milk peddlers dip milk with a long dipper from the 
large milk can, and instead of obtaining milk from these cans by means 
of a faucet, tbey dip it up witb long-handled dippers. The probabilities ' 
are in favor of the fact that Henry Smith frequently had diphtheria bac- 
illi on his bands, and every time he splashed this dipper in the can the 
milk in the can was infected from it. I think there is little doubt that 



OHIO STATE BOARD OF HEALTH. 3O3 

this epidemic of diphtheria was caused by milk infection in this manner. 
The extreme rarity of milk epidemics of diphtheria makes this one pecul- 
iarly interesting from the epidemiological standpoint. 

Now, as regards treatment with anti-toxine. That is one thing that 
chiefly interests us. On the 17th of December, Dr. Hopkins procured 
some anti-toxine from New York. There was in the town at that time 
three cases which were said to be of the most malignant form. These 
were the most malignant cases I saw while I was there. Out of these 
three cases, two died. The first case was a child six years of age. After 
anti-toxine, was administered he lived two days, and I have no doubt 
that, while it was a severe case, anti-toxine prolonged his life. The 
second case was very severe— a woman twenty-seven years of age, who 
had been sick for six days. She was attended by Dr. Flower. He was so 
much impressed with the gravity of the case that he called in another 
physician with a view of getting his opinion. The physician agreed with 
him, and they thought the woman could not possibly recover. That was 
three days before I saw her— on the 17th of December. We gave her 
two injections of anti-toxine that day, and on each of the four succeeding 
days we gave her one injection of anti-toxine. On the morning of the 
fifth day after the first dose of anti-toxine she appeared better than at any 
time during her illness ; certainly better than at any time I had seen her. 
Her pulse was good and strong and the heart sounds quite strong. The 
false membrane had entirely disappeared from her throat and she looked 
quite well. Suddenly, late in the afternoon, we called to see her, and 
found her gasping for breath, pulseless at the wrist, the heart sounds 
scarcely audible, and her lungs soon clogged up and she died in a short 
time. That was the second fatal case, although I have no doubt that her 
life was prolonged several days by anti-toxine. The third case was a child' 
four months old. I saw it on the third day of the disease. This child 
had lost its father and grandmother of diphtheria. The child's tempera- 
ture was 105, and the third day after anti-toxine was administered the 
naembrane disappeared. This was a severe case of "mixed infection," 
and the child probably recovered from the diphtheria and died of 
septicemia. 

Now, these were all the deaths we had in cases we treated with anti- 
toxine. Twenty-eight cases received the anti-toxine treatment, and out 
of this number three died, which was, of course, very much less than 24 4 
per cent., which had characterized the epidemic before that. Since I have 
rendered my report to Dr. Hopkins there have been six other cases at 
Ashtabula that I learned of since which were treated with anti-toxine; so 
the last six cases, added to the twenty -eight that I previously mentioned, 
makes thirty-four cswes, with only three deaths. So that brings down 



304 ANNUAL REPORT 

the mortality of the anti-toxine cases to 8.82 per cent. Of the twenty- i 
eight cases, of which I have notes, treated with anti-toxine, five were mild 
cases. There were ten severe cases — and seven cases being very severe — a 
question of almost life or death, and at any time during the illness very 
severe cases. Now, the amount of anti-toxine given varied, according to 
the case. We used it as we would any other remedy, as the condition of 
the patient seemed to require. We gave ordinary doses on the first day, 
and the second day we repeated it. If the case was a severe or malignant 
one we would give a strong initial dose and would return in a few hours 
to see how the case was getting along. 

It would be of interest, if time permitted, to say a few words about 
the different varieties of anti-toxine that are on the market, and which, I 
am glad to say, can be obtained now by physicians for the treatment of 
their cases. The anti-toxine used at Ashtabula was obtained by Dr. 
Hopkins from the Pasteur Institute of New York City. In our hands it 
proved satisfactory, the patients reacting typically. We usually injected 
it into the soft tissues of the buttocks. The patient rarely complained of 
pain, and we have had no abscesses following the injections, though we 
have had several cases of luticoria. I am inclined to think that eventually 
anti-toxine will absolutely cure a large portion of cases of this disease if 
administered at the proper time. It is beyond the experimental stage, 
but many thousands of cases must be studied before its exact value is 
determined. 

Dr. Linden, of Brooklyn : While the papers have been very interest- 
ing and the discussions have been interesting, especially from a medical 
standpoint, still, we should not lose sight of a preventive treatment for this 
disease. These troubles, I think, in these cases, could have been avoided 
by boiling this milk. If the milk had been thoroughly boiled these 
people would certainly never have had diphtheria. I believe the repre- 
sentatives of boards of health should caution the people in their com- 
munities to be more careful in the preparation of their food. Inasmuch 
as these epidemics occur not only in Ashtabula, but in other places, it 
would be well for us to warn the people against the danger of milk infec- 
tion and other food supplies. The milk should be thoroughly boiled, 
especially during a time an epidemic is threatened. I think we should 
take every means possible to prevent these diseases, and not wait until 
the disease comes and then try to procure some remedy which will cure. 
I say that prevention is worth a good deal more than cure. 

Dr. Sutton, of Zanesville: Mr. Chairman, I wish to say that a few 
months ago a physician reported a case of diphtheria to me and he stated 
that it was a very malignant case ; that he had no idea where it had come 
from, there being no cases of the sort there in the neighborhood, so I went 



OHIO STATE BOARD OF HEALTH. 305 

right to the house myself and put a card on it. When I went to record 
the case I saw the last case was recorded eight months before, because I 
attended it myself, it being right across the street; and I remembered 
having seen some changes made about the place where I had attended 
this case of diphtheria, and I drove back up there and went into the 
house and asked if they had been having some buildings moved or torn 
down, and the lady of the house informed me that last week — the week 
belore— they had their vault cleaned. 1 hereupon I went and saw the 
man who had cleaned the vault and asked him if there had been any 
children around there when his men were doing this work, and he said 
that this little boy was there and they could not keep him awa3^ He 
said he was in the way all the time. That is the history of the case„ 
There can be no doubt of the way he caught the disease. 

Mr. Walton, of New Burlington : I simply want to say that I am 
very thankful for the instruction and information that our physicians 
have given us, and I believe that a little warning to the doctors might 
not be out of place. I have had a remarkable experience with diphtheria 
myself. In 1869 I had three interesting little children. One of them 
was a little indisposed, and we called in a physician. He thought there 
was but very little the matter with the child, but in a day or two 
diphtheria in a malignant form developed, and inside of nine days our 
house was left childless. We knew of no way the children could have 
gotten the diphtheria but by being carried by the physician. None of us 
were so airaid at that time of this disease. Subsequently we learned that 
this physician had been attending a malignant case of diphtheria, and 
there seemed to be no other way by which they could get it except by 
being carried in his clothing. So, while I ieel that our physicians have 
the interest of the sick in their hearts in this matter, I think the experi^ 
ence which I have related might be a caution to some who have not ha(J! 
experience with diphtheria. 



FOURTH SESSION. 



Friday, 9 a. m., January 25, 1895, 

The Chair : In the absence of Dr. Woods, the first subject we will 
discuss this morning will be, ''What Precautions are Necessary in the 
Burial or Transportation of a Corpse When Death was Caused by Typhoid 
Fever ?" The discussion will be opened by Dr. S. P. Wise, member of the 
State Board of Health, Millersburg. 

20 ST. B. H. 



J06 ANNUAL KEPORT 



WHAT PRECAUTIONS ARE NECESSARY IN THE BURIAL OR. TRANS- 
PORTATION OF A BODY WHEN DEATH WAS CAUSED 
BY TYPHOID FEVER? 

By Dn. S. P. Wise, Member State Board of Health, Millersburg. 

in estimating the danger of contracting disease from dead bodies we have but very 
iimited data from which to draw our conclusions. It seems that bacteriologists have not 
proceeded very far in the direction of ascertaining the virulency of specific germs con- 
tained in the bodies of persons who have died of acute infectious diseases. I^o far our 
knowledge is limited to a few stray facts which have been incidentally discovered in the 
sourse of investigation of epidemics. There is, no doubt, a large unexplored field before 
^6 which will yield valuable knowledge whenever the subject is brought fully under the 
light of scientific research. We know from practical experience the extreme danger of 
(Contracting small-pox from the bodies of persons who have died of that loathsome 
disease. Even after having been buried many years the malady has been communicated 
to the living where such bodies were exhumed. We also have many authenticated 
Instances on record in which persons who came in close contact with the bodies of those 
who died of scarlet fever and diphtheria have contracted those diseases. These facts 
^ave all been practically demonstrated, and there is no doubt concerning them. In the 
management of cholera epidemics the rule is universally adopted and strictly enforced 
ihat the cholera dead shall be promptly disinfected and speedily buried, with all the 
possible precautions. I apprehend that the transportation of the body of a victim of 
cholera would be considered absolatelj' criminal by all sanitary authority, and yet there 
is no scientific proof that the disease can be communicated by a dead body. The only 
medium of communication is, in fact, the clothing and bedding of the patient which 
Slave been soiled with choleraic discharges. 

Now, when we come to consider the question of post-mortem transmission of the 
Specific contagion of any of the infectious diseases from a scientific standpoint we are at 
once confronted by the question. How long will the germs of disease survive in the body 
after death? Will they retain their virulency for any length of time after decomposi- 
tion has begun ? Unfortunately we have no knowledge on this point with regard to 
lyphoid fever, for the reason that the disease cannot be produced in the lower animals. 
We are therefore obliged to form our conclusions by analogy. The comma bacillus of 
cholera infests the intestinal tract; so, also, does the bacillus of typhoid fever. In either 
(Base it is necessary that the specific germ gains access to the intestinal canal in order to 
produce the characteristic disease. It is, of course, clearly demonstrated that it is not 
the germs themselves that produce the toxic effects, but it is the ptomaine or poison 
which they secrete. In other words, it is not the fly which does the mischief, but it is 
the "speck." There is another point of similarity between the two diseases ; that is, that 
the contagious principle is contained in the bowel discharges in the most active form in 
typhoid fever, as well as in cholera. We see, then, that cholera may be fairly taken as 
an analogue of typhoid fever in so far as the parts affected are concerned. They differ 
widely, however, in the nature and malignancy of the germs which produce them. The 
eholera bacillus is by far more malignant than is the bacillus of typhoid fever, and we 
would naturally suppose that it would retain its potency for a longer period of time in 
the cadaver. Dr. Vincent R chards, of India, made some experiments which throw light 
on this question. He removed the contents from the bowels of persons who had died of 
eholera and administered them to pigs. He found that the animals died in a few hours 
with cholera, providing the fluids were taken from the corpse of a patient who had died 
quite recently — within two hours. But where a longer time had elapsed and the fluids 
were in the least offensive, the animals remained unaffected. These experiments prove 
«»nclusively that decomposition will destroy the cholera poison quite promptly and 
(BfFectually. In view of these facts, we are justified in the conclusion that the same result 
takes place in the bodies of persons who have died of typhoid fever. This would 



OHIO STATE BOARD OF HEALTH. 307 

especially seem reasonable when we consider that the typhoid germ is far less virulent 
than the cholera germ, and would in all probability be less resistant to the action of the 
bacteria of decomposition. 

It would appear, then, that there are no scientific reasons why the cholera dead 
should not be transported without extra precautions, no more than there are in the case 
of typhoid fever. In either disease the contagious principle is contained within the 
alimentary canal, and in a few hours after death it is rendered inert by the process of 
decomposition. Moreover, there is no doubt that many thousands of autopsies have 
been held on the bodies of persons who have died of typhoid fever and cholera, and yet 
we never hear of a physician who has contracted either disease in that manner. The 
reason is simply because the autopsies are held alter the process of decomposition has 
accomplished its work. 

The rule that should guide us, however, in all sanitary questions of this character, 
is that we should always err on the side of absolute safety. As I stated in the beginning, we 
have a great deal to learn yet on this subject. When life becomes extinct — no matter 
from whatever cause — the human body becomes a decomposing mass of organic matter. In 
the process of decomposition, ptomaines are generated which, in their effects on the liv- 
ing organism, resemble the venom of the most poisonous reptile known to mankind. 
We cao well imagine that the affluvia arising from a corpse may contain poisonous ele- 
ments which are highly dangerous to health. It is therefore nothing more than good 
sanitation that every possible precaution be taken to prevent the diff^iision of those gases, 
even if it cannot be proven that they contain the elements of contagious diseases. I 
would therefore insist that all bodies, no matter what the cause of death may have been, 
should ba hermetically sealed before they are accepted for transportation by any com- 
mon carrier. I would urge the adoption of this rule for aesthetic reasons, in the name of 
good sanitation and common decency. 

For instance, let us take a view of the conditions which often necessarily arise in 
the average express car while a corpse is en route to its destination. Here is the box 
containing the body placed on the floor of the car. On top of the box, piled up to the 
ceiling, are crates of strawberries or boxes containing oranges or other fruit. By the 
side of the rough coffin, nestled closely up to it, rests a dainty little basket containing 
some choice rolls of butter which some kind country matron is sending to her city friend. 
Perhaps on the other side, setting on edge leaning against the box, we find a large Swiss 
cheese. Now, I beg leave to ask, who would want to partake of those eatables if they 
knew the circumstances attending their transportation ? The mere thought of such a 
condition of things would create a disgust in the mind of the average person, even if 
they knew that no perceptible odor had escaped from the corpse. I do know, however, 
and I think every express messenger will bear me out in the assertion, that in the msjor- 
ity of shipments there is more or less odor, and oftentimes it amounts to an actual stench 
if the containers are not hermetically sealed. 

As regards the burial of persons who have died of typhoid fever, the same conclu- 
sions heretofore mentioned are applicable as far as the direct contagion from the body 
itself is concerned, but a different class of conditions are present at funerals which de- 
serve special consideration. Without entering into a scientific discussion of the subject, 
I would briefly say that we have no positive assurance that the typhoid germ may not 
be found floating in the air of the room in which the patient was sick, especially where 
the necessary precautions of absolute cleanlineES and the disinfection of stools have not 
been strictly observed. The bedding and clothing of the patient, and other fabrics con- 
tained in the apartment, may harbor the contagion. There is no reason why this may 
not be the case in typhoid fever as well as in cholera. Therefore the corpse and the sick 
room should be subject to the same sanitary measures that apply to all other contagious 
diseases. In order to insure absolute safety, persons would do well not to eat or drink in 
a house where the disease has recently prevailed, especially where the g'ame members of 
the family who have nursed the sick also engage in the preparation of the meals. The 
reprehensible custom which is still in vogue in some of the rural districts of holding a 



308 ANNUAL REPORT 

feast at the home of the deceased, to which neighbors and friends are invited, should 
therefore be abolished. 

Dr. Hopkins, of Ashtabula : I am somewhat interested in this mat- 
ter. I have been a little anxious to have this matter of contagious 
diseases brought before us and to discuss the methods of handling them 
in a way to protect our people. Now, if there is danger of funerals at a 
house, why, of course, we find that same danger to a certain degree in 
some other places, because we have not gone through certain processes of 
disinfection for protection. If we should allow that, would we allow a 
scarlet fever case, after we had thoroughly disinfected the body, to be 
carried to a church? If there is an element of danger, I am like the 
speaker — I believe in going cautiously. If there is any element of danger, 
let us not have any such funerals. I do not mean to say that we should 
not have any funerals, but I think in cases of contagious diseases funerals 
should be piohibited. 

During the diphtheria epidemic at Ashtabula we buried many a little 
child inside of six to eight hours, and no one went to the funeral — none 
from the house went to the funeral. 

Now, as to the transportation of bodies. I got into a little trouble 
myself in transporting one of these little bodies to Cleveland. I did not 
think at the time that I had endangered anybody, and don't think so 
now ; but I found out before that body got to Cleveland that I had trans- 
gressed the laws of our State Board of Health, though the body was disin- 
fected thoroughly and wrapped in a sheet wet with bi-chloride solution 
and the casket hermetically sealed. I thought I would bring that matter 
up before our meeting. 

Mr. Ranney, of Columbus: If there is no danger of diphtheria, scar- 
let fever or typhoid fever to parties who may attend funerals, from the 
dead body, it seems to me there is danger from another source ; that is, 
the apparel worn by the members of the family where this disease existed 
may become infected. I can see very readily how the health of those may 
be impaired who have not even been near the house. Therefore I should 
be opposed to public funerals where death has been caused by contagious 
diseases. 

Dr. Wise, of Millersburg : I would like to have heard more expres- 
sion on this subject in reference to transportation of those dying with 
contagious diseases, and it seems to me it would be well, as I stated in my 
paper, to be on the side of safety. I believe that public funerals ought to 
be discarded. 

The Chair: Our next topic for discussion will be, "When Small- 
pox Alights in a Village, Then What ? The discussion will be opened by 
Dr. J. T. Woods, health officer, Toledo. 



OHIO STATE BOARD OF HEALTH. 3O9 

WHEN SMALL-POX ALIGHTS IN A VILLAGE, THEN WHAT? 

By Dr J. T. Woods, Health Officer, Toledo. ■ 

This query presents such a variety of probabilities and possibilities that even an 
approximate answer can be made only on the basis of conjectural grouping of cir- 
cumstances. 

But before entering on this task I may be pardoned a brief preliminary, bearing 
more or less on the general features of the subject. I think it both safe and proper to 
say that the mass of the interested public are but illy informed as to the loathsomeness, 
as well as the danger, of this disease. Few of them have seen a case at any period, and 
fewer still when in its worst stage. Their conception of it is of necessity based largely on 
hearsay and conjecture derived therefrom, both of which are liable to be discounted in 
their final conclusion as to its character and quality. They have but faint idea that the 
poison may lurk in the most costly fabric as well as in rags; that its traces may be found 
in hotels, carriages, street and railway cars ; that the air in an infected district is far from 
safe; in brief, that it is possible to become contaminated in the most unexpected ways 
and places; that this disease is thoroughly cosmopolitan, making no distinction as to 
age, sex, or condition of life. 

Whether it be from a lack of knowledge and appreciation or not, the fact remains 
that the general public are to a great extent practically somewhat reckless, for whether 
the purpose be business or pleasure, few persons decline to visit a locality where the dis- 
ease is known to be rife, probably presuming, as do soldiers when going into battle, that 
the party to be injured is anyone but themselves. 

The manufacturer of clothing pays little heed to the possibilities of his sweat-shop 
made garments being infected, and therefore certain to develop the disease in the wearer. 
The second-hand clothing dealers push their business with but little regard to the ter- 
rible possibilities. A large part of the public are negligent of their own vaccination 
and revaccination, and shrink from the vaccination of their children as if it were a fatal 
poison, and to a great extent submit only because school boards may and do prohibit the 
unprotected from attending school, while on the other hand the truant officer is a terror 
that they cannot escape. 

The knight of the highway, whether he tramps to obtain work or to avoid it, is 
totally indifferent as to his clothing and company, eats and sleeps in any kind of a den. 
Wholly innocent of soap and water, he dons any kind of clothes that will hide his 
worthless carcass, that he may be in the best form to ask alms at the doors of the frugal 
innocents, whose pity for the forlorn liar prompts them to contribute to his needs, pos- 
sibly to receive in return a contribution from his pathetic raggedness — a contribution 
that will cause them to remember him to the end of their lives. Thus through legiti- 
mate travel and trade, through both travel and trade that should be illegitimate, but 
especially through the ever-weary pilgrim of the highway, the most remote and unsus- 
pecting community is liable to a shocking surprise. 

It is true that those situated on the chief lines of transit are the most liable, but it 
is equally apparent that the liability extends to the most secluded home and hamlet. 

If these facts were appropriately considered by those in authority it would result in 
more or less preparation for the unwelcome visitor, preparations that in the trying hour 
would be of infinite comfort and value, and if that hour failed to come, an appreciative 
community would still have ample cause to be thankful. But I am expected to deal 
with things as they are, instead of as they should be, and to make such answer to the 
query as I may be able. 

The circumstances will necessarily vary, and what is to be done must be so adjusted 
as to as nearly as possible, meet the demands of the hour. If we suppose a town or city 
in which preparation has been made for a possible visitation — where an active health 
board has taken time by the forelock — we will find a capable and energetic health officer, 



3IO ANNUAL REPORT 

a more or less trained and fearless sanitary force ; a detention hospital for homeless or 
other suspects during the period between arousing of suspicion and the time when the 
diagnosis can be made certain ; and apart, and some distance removed, a contagious dis- 
ease hospital for treatment of the cases that proved to be genuine. An ambulance, or 
some other appropriate means for transportation of patients, must be provided and in 
readiness. Whether the patient is quarantined in his own home or in the detention 
hospital, all persons, however slight the exposure, are to be vaccinated. All those to 
whom the exposure is deemed in the least perilous are placed under strict guard, and all 
others, however remote the possibilities, are kept under observation. If the case in hand 
proves to be small-pox, and the patient is taken to the hospital, dangerous clothing and 
bedding are burned and the house thoroughly fumigated, and every possible trace of 
contamination removed from the persons and clothing of the occupants that are to be 
continued in quarantine. The sanitary men thus engaged must be protected by either 
having had the disease or a very recent successful vaccination, and, when handling the 
patient or fumigating the house, should wear a complete outer suit of rubber clothing, 
including a rubber cap, with cape and face cover, and rubber gloves for the protection 
of the hands. The same is demanded of the attending physician, and this whole protec- 
tion outfit is to be fumigated after each exposure, and thus kept in readiness for future 
service. All attendants, either at home or in the hospital, being continually exposed, 
must be protected by vaccination, or, preferably, should be those who have had small- 
pox. 

This recital, somewhat brief and incomplete in detail, serves to show the nature of 
the barrier to be maintained by the health department between the patient and the pub- 
lic, the omission of any part of which is fraught with danger. If, on the other hand, we 
supposed that a case occurs in which few or none of these preparations are made, embar- 
rassment is found on every hand, but the line of action should be in accord with and as 
nearly as possible attain the same end as I have just detailed. A person having his own 
home may be quarantined there, and a little time taken to secure any protective articles 
that may be necessary, as well as the services of a physician, but he and all concerned 
should be required to observe the caution and care I have just indicated. 

The real difficulty, however, arises when the party is homeless, perhaps a stranger. 
Humanity and duty unflinchingly demand that he be cared for and the public afforded 
a full measure of protection. He may be found in a boarding house, a saloon, in prison, 
or anywhere ; hut wherever it may be, the health authorities are called upon to remove 
him at once. No family will accept him, and he can be forced under no man's roof. 
There being no detention hospital, no small-pox hospital, no sanitary force, they must 
be improvised. A medical man must be found who will take charge of the case, a cook 
and nurse who enjoy protection and are willing to undertake the service. These parties 
must be faithful, fearless and willing men — men of good judgment and steady nerve. 
An airy, a flighty or a drinking man will almost certainly lead you into difficulty. 
From a moderate experience I have learned to rely only on staunch, thoughtful and 
strictly temperate sanitary men. I have also learned that the larger part of those who 
offer their services are valueless, or worse, but in an emergency such as I have supposed, 
the best that can be done must be accepted and a sharp lookout kept to detect and cor- 
rect negligence and any possible variation from strict duty. 

But to be more specific as to detail, the first embarrassment lies in determining 
positively that we have a case of small-pox and nothing else. A stranger comes into 
your village. He is perfectly well at the time. After a few days he feels somewhat ill ; 
suffers from headache and aching of the back, has more or less fever and a high temper- 
ature. All these indications may be slight. Presently certain spots appear about the 
face, and in a short time small papules appear on the forehead. He may or may not 
have some soreness of the throat. With the appearance of the papules he feels better. 
There is little in this and other symptoms to arouse the suspicion of an unsuspecting 
physician. If suspicion is aroused, that is not sufficient; it must be a certainty. The 
first patient is to be treated as a victim of small-pox, or he is not, and even an expert 



OHIO STATE BOARD OF HEALTH. 3I£ 

♦ 
hesitates until the vesicles form and commence to pit. Capable men have felt sure, sent 
the patient to a hospital, and have had occasion to bitterly regret it. Unfortunately a 
large portion of medical men have never seen a case of the disease, especially in its early 
stage, when accurate diagnosis is the all important question. The protection of a com- 
munity demands that as few persons as possible should be exposed to a suspicious case, 
thus depriving medical men of an opportunity to learn that which they afterward may 
be blamed for not knowing. 

1 have just stated that a suspect who has a home may be quarantined there, at least 
until it is clear that he is certainly afflicted with the disease ; and it may be best under 
certain circumstances to continue treatment there. In the case of the homeless, who 
must be secluded, I can only suggest that possibly an empty house that is worth but 
little may be found, that is so situated that it would be appropriate for use. All that is 
absolutely necessary is to protect the patient from the inclemency of the weather for the 
brief period during which he remains a suspect. In the absence of such a house or shed, 
a good tent with fly might be quickly obtained that would in warm weather serve every 
purpose, and if supplied with a floor and stove and placed in a position that would pro- 
tect it from chilly winds, would answer very well for the entire course of the disease. 
The attendants who have charge of the patient during this preliminary stage should be 
continued to the end ; and if the detention hospital be used, the attendant there should 
go with him to the small-pox hospital as his nurse, thus saving the quarantining of one 
person. If either the old house or tent be used for detention, and the case proves to be 
small-pox, they should be thoroughly cleansed and fumigated, or, preferably, destroyed 
by fire. Of course there should be a free display of cards and a yellow flag plainly 
marked with the word "Small- pox," that all may be warned of danger. 

After death or recovery, too much care cannot be taken in destroying or cleansing 
and fumigating the building and all its appurtenances, including every article within 
or without the structure. In this particular I fancy that mistakes are liable to be made, 
and the work should either be done or overseen by an exceedingly careful, persistent 
and level-headed man. In fact, these are qualities required in all parties directly 
interested from the beginning to the end. 

As a substitute for an ambulance I have known a patient in the papular stage to be 
taken to a hospital in a buggy, having been dressed in a rubber outfit, as previously 
described, and a sanitary man equipped in the same manner acting as driver. 

In conclusion I desire to say that I have not attempted to lay down rigid and 
inflexible rules, but rather to suggest what would seem best to be done, always remember- 
ing that circumstances alter cases, that to do the best that the situation admits of relieves 
the performers of all reasonable responsibility, be the results what they may; but, 
withal, urging health boards and health officers throughout the State to make such 
preparations as are possible before the calamity is at their doors. 

The Chair : The subject is now before you for discussion. Has any- 
one anything to say upon this subject? 

Dr. Probst: Mr. President, I wish, if possible, to emphasize one or 
two points made in the admirable paper just read. The doctor advises 
us to select only careful, temperate men for guards or sanitary policemen 
when dealing with small-pox. This is very important, as careless or 
drunken guards may themselves spread the disease. I have known 
several instances of this kind. A man set guard to a small-pox patient 
often imagines that he requires a little black jug to keep up his courage, 
or his circulation in cold weather. 



312 ' ANNUAL REPORT 

An instance at Akron shows how easily small-pox may be spread by 
careless guards. One case there was being guarded by a German who had 
had small-pox. There was also a German nurse who had had the disease. 
On one or two occasions, as we afterwards learned, the nurse came out of 
the house and, standing on the inside of the fence, talked to the guard 
who was outside. This guard carried the disease home to his wife. She 
had been well vaccinated, and had such a mild attack of the disease that 
no physician was called. They claimed, in fact, that they did not know 
she had the small-pox. A couple of weeks later her young babe, which 
had not been vaccinated, was taken sick, and had a severe attack of 
small-pox. A physician was then called, and it was not tiJl then that the 
exposure of the guard to the nurse was known. Another lesson to be 
derived from this case is the necessity of vaccinating all members of the 
families of those who have iu any way to deal with small-pox. 

Another thing with reference to guards and nurses should be remem- 
bered — we always select, where possible, those who have had small-pox. 
These persons should be vaccinated, for it is not so very rarely that a person 
has the disease a second time, and may thus spread it. One of the nurses 
employed as nurse at Akron, and who had had small-pox, contracted the 
disease from his patient. Fortunately he came down with the disease 
while still in quarantine. 

When you are quarantining a family at home, and guards are 
employed, you should have both day and night guards. It is impossible, 
otherwise, to insure that someone will not enter or leave the house. 

I remember an instance at Ponjeroy, during their small-pox epidemic, 
illustrating this point: Two or three cases of small-pox occurred in a 
large family of Germans who lived in an isolated house on the outskirts 
of the town. A guard watched the house from daylight to dark. A 
week or more after the guard was placed there we found that the grand- 
mother of the children who were sick went regularly to the house every 
night, and returned to her home before morning. 

It is only by the most careful oversight of small-pox cases that we 
can successfu ly quarantine this disease in the house of the patients. 

Dr. Hopkins, of Ashtabula: Mr. Chairman, I have been very much 
interested in this paper. We had one outbreak of small-pox in our town, 
since I have been health officer, and we kept that in the home. We had 
at that time an old building that we called a pest house, and it was a pest, 
and thank the Lord it has burned down. But I have thought a good 
many times since then what would I do if small-pox should alight in 
our town. I have talked with our board of health and our council in 
regard to a detention hospital, or pest house. We have a population of 
about 10,000 or a little over, and I should like to know whether it is 



OHIO STATE BOARD OF HEALTH. 313 

advisable for us to go to work and build a detention hospital, or whether, 
as suggested in the paper, we should get some old house or a tent or some- 
thing of that kind. Of course we have come here to learn something and 
get some practical suggestions, and we certainly have got a good many 
out of this paper, and a good many from Dr. Probst. I would like to ask 
just one more thing. Dr. Probst says we should have our guards there 
night and day. I know I got a nurse to help out a family who had 
small-pox. She was not afraid of it, but she was one of the kind that 
needed a small jug to keep her from taking it, or to cheer her up, and one 
night the family reported that their nurse was gone. I scoured the town 
to find my nurse, but could not find her. I worked faithfully for several 
hours and finally gave it up. The next morning I found her and I tried 
to find everybody with whom she had come in contact. I vaccinated 
everybody I could find who had been in that part of the ward. I insisted 
that she must return. This she declined to do. Thereupon I told her 
I would have to do something with her — that I should have to put her 
under arrest, and would make her all the trouble I could. She finally 
agreed to come back and did so. We were lucky enough in that case not 
to spread it We had a guard on duty at all times, and it was in the 
dead of winter. You know we have got to have some place for the man 
to stand. In the evening, on that bitter cold night, our guard had a room 
just across the street, where he could keep warm, and still keep oversight. 
However, he did not have his eye on that nurse I will promise you. The 
guard should have a temporary building right by the house in order that 
he can watch such cases, and keep people who are in the house from leav- 
ing the house and thereby spreading the disease, as is the case in a great 
many instances. I should like to hear from a great many others and 
their opinion as to whether it is wise to go ahead and put our city to the 
expense of constructing a permanent pest house, 

Mr. Shachleiter, of Ironton: Gentlemen, with reference to a pest 
house. I would like to know at Ironton what distance the pest house 
should be built from the city, and whether on lofty ground or on a 
meadow. There is quite a difference of opinion in reference to their loca- 
tion. We have several isolated places selected for a pest house, but we 
have not yet come to a conclusion which one to purchase. The trustees 
are in favor of dedicating a certain park out of the city for pest house 
purposes In the discussion I would like to know the distance generally 
of those isolated places from a city, and also what mode of transportation 
is usually adopted to get back and forth. We should be very much 
pleased to hear from the doctor in reference to the work there and else- 
where, so that if we apprehend any great epidemic we can prepare for it. 
We live down on the Ohio and we cannot tell what may happen, but so 



314 ANNUAL REPORT 

far we have been very fortunate through the efiforts of our competent 
health officer in seeing that we have a good sanitary condition existing in 
Ironton to avoid epidemics. 

Mr, Fee, of Warren : We had a little experience in the way of a 
pest house. A number of years ago, outside of the city we selected a 
place in which there was a beautiful grove, and it was only accessible by 
passing through the cemetery and across two railroads. The authorities 
built a pest house, a frame structure, one story high, and about twenty by 
twelve feet, plastered inside, windows and doors, and a partition in the 
middle, making two rooms. We supposed this to be ample for us in case 
of necessity, and kept it there in repair for a number of years. Fortu- 
nately we never had occasion to use it. The house has gone into decay, 
been injured very greatly by tramps, who frequented that isolated spot, 
and it has been a source of great trouble. They carried off the windows 
and window sills and doors, and used them for kindling and campicg 
fires. We have repaired the building once, but I understand that it is in 
a very deplorable condition to-day. 

Dr. Hedges, of Delaware :' I was very much pleased with the doctor's 
statement. I think he covered most of the ground in reply to this ques- 
tion. As to the question of pest houses, I don't believe that small cities, 
or even large cities, can maintain and keep up a pest house. I don't be- 
lieve that it is necessary for a city of from 8,000 to 10,000 people to have 
a pest house. I am informed by members of the board of health at 
Delaware that two pest houses had been built and were both destroyed — 
burned by somebody. The people naturally have a dislike lor those 
things. Some one eventually will burn them. If you have a pest house 
the only thing to do is to have it occupied by somebody living in it who 
can take care of it. It is the only way you can keep up one. If a person has 
a good home the people can be isolated in the home. It has been done in 
our city, and without the spreading of the disease at all. A few years 
ago a man came to my office covered with small-pox pimples — a student 
in the University. I told him he had small-pox and advised him to go 
to his room and I would turn him over to the town authorities. The 
city council took care of the case. The young man went to his room, and 
his room mate remained with him and took care ot him. The house was 
quarantined thoroughly and the young man was cured and there was no 
spreading of the disease. The student was vaccinated immediately, as 
was also the physician who attended the small-pox patient, and the dis- 
ease was stopped there. Other cases have occurred in the city and been 
treated that way. 

A Member : The subject of a pest house or hospital is something I 
believe the majority of the smaller cities are considering at the present 



OHIO STATE BOARD OF HEALTH. 315 

time. Our attention has been called to a hospital used by the German 
army. I will not go into details. It seems to me that somebody — some 
member of the State Board interested in the subject — should look into 
this matter more in detail. This hospital spoken of can be taken down 
and fumigated and made absolutely proof against contagion. I simply 
refer to this in the discussion. 

A Member : From a business stanc^oint I consider it a very impor- 
tant matter to look after the proper methods of taking care of and quaran- 
tining cases that may come to our respective towns. I think the matter 
of a tent hospital is a very good one, and I came to the conclusion that 
it was a most valuable way of taking care of most of these cases — think 
it makes a splendid temporary pest house. After you are done with it it 
can be thoroughly fumigated, so there is no possibility of contagion from 
it thereafter. For my own part, I think temporary hospitals are all that 
are needed. 

Mr. Wickham, of Findlay : Gentlemen, I want to say to you, in case 
we had small-pox at Findlay — and I presume that a majority of the towns 
represented here are in the same fix — that we have a number of vacant 
houses, large and small, standing in the suburbs of the town and isolated 
from one another, and I would say to our brother health officers, should 
they come to me, that I would seize one of those houses, and have it re- 
paired if necessary, and use it for a hospital. And after the case had 
been disposed of, I would have it condemned and burn it down. 

The Chair : Gentlemen, the next subject for discussion is, " Well 
Pollution in Relation to Typhoid Fever, " the discussion to be opened by 
Mr. Josiah Hartzell, member State Board of Health, Canton. 

WELL POLLUTION IN RELATION TO TYPHOID FEVER. 

By Mr. Josiaii Hartzell, Member State Board of Health, Canton. 

The existence of micro-organisms has been known ever since the discovery of the 
microscope in 1675. This knowledge had no special interest to physicians until about 
1850, when Da Vaine, a provincial French doctor, demonstrated that certain infectious 
diseases of animals are due to microbic action. It happened that one of these dis- 
eases — anthsax — was common to both animals and men. Thus was the key to facts 
underlying the germ theory given a real turn, and a new gateway, opening upon 
realms of unspeakable import to the human family, for the first time in the world, 
stood slightly ajar. 

Among thinking men there had been a settled belief that sudden and simultaneous 
outbursts of contagion were due to living reproductive organisms. There had been, also, 
an indescribable craving and yearning for light and hope. Both came to those who 
grouped in the darkness, not with a flourish of trumpets on the mountain top, but hope 
with Jenner, the humble English doctor, and light with Da Vaine, the equally humble 
French physician. 

Closely following the diflerentiation of the bacillus of splenic fever, and more espe- 
cially after Pasteur had silenced the doubting Thomases by the crushing logic of his 



3l6 ANNUAL REPORT 

sterilized cultures, there was a tumult of prophecy. The bewilderment of immediate 
and unfulfilled expectation was fraught with discouragement, and theorists and anti- 
theorists pulled apart harder than ever. It was only another example of the niggardli- 
ness with which Nature doles out the treasures of knowledge from her storehouse of 
mysteries, and even then without permitting a "why" or "wherefore." 

We ask, why does the apple fall? Gravity. Why does gravity pull the apple 
down instead of up? That is the end. Again: Why is grass green? Because of the 
action of the sun's rays on the clorophyl. Why does the sunlight turn the clorophyl 
green, instead of red or brown ? Again we find the door slammed in our faces. Why 
does quinine neutralize malarial poison? There is no response. Edison was not so far 
wrong when he declared that, "We don't know the millionth part about anything. " The 
wisest men are those who know that they know the least. 

Thirty years of unremitting experiment and research had to elapse after Da Vaine 
before the romance of the invisibles had been in any way pushed aside to make way for 
scientific truth. Then for a few years some of the authors of the woes of mankind were 
caught in pairs. First the inciting causes of leprosy and gonorrhcea in 1879; of typhoid 
fever and pneumonia in 1880 ; of consumption and glanders in 1882; of cholera and 
diphtheria in 1884. Since the date last named there has been but one addition to the 
list, namely, the microbe of influenza in 1892 

It may be said that this rate of progress has been slow. Measured by our desires 
that is true, but the list of diseases that can be diagnosed by the microscope is gradually 
lengthening. If an accounting is taken of the difficulties that have had to be surmoun- 
ted, that which has been accomplished is the marvel of the closing century. The invisi- 
ble world swarms with micro-organisms whose functions are mostly benign. Their habi- 
tat is in the body and out of the body. Almost all the phases of organic life, of growth 
and death, of assimilation, of decay and rehabilitation, are due to them. If from these 
families of organisms, the numbers of which are identifiable only by infinitesimal, and 
almost indefinable traits, it has been possible to select out some of the culprits, and to 
fix their guilt by the irrefragable test of isolation in sterilized cultures, it has been due 
to deft hands, to an infinite patience, and to a faith and a courage which should chal- 
lenge the admiration of the philanthropic heart. 

If statues and monuments have been built to poets and statesmen and orators, why 
not also to those who have placed the conservation of the public health on a rational 
foundation. It is time that our world of to-day abates something from its worship of the 
chiefs of war ; of those who by the acoident of battle, or by the skill of intrigue have 
filled historic pages, and bear a more willing testimony of gratitude to those whose mis- 
sion it has been to save and not destroy. These, too, have fought a good fight. They 
have braved prejndice. They have fought the invisible enemies of death, and have 
fought on while the world laughed. They have vanquished enemies ten thousand times 
more potent than the hosts of Xerxes and Ciesar. They have chased away the blinding 
phantasms and empiricisms that enshrouded the foundations of a noble calling, and have 
thrust into their places the granite rock of established science. Into the world's life; 
into the houses of the highest and lowest alike, they have flashed, not the lurid gleam of 
hate, nor the conscript's terror, but the glorious and healing gleams of safety and hope. 

These observations may be styled irrelevant. They are not. It is due that the 
instrumentalities that have rendered possible the rational discussion of a subject of this 
nature ; that have ferreted out and exhibited to us the causes and results of certain phe- 
nomena, should receive proper mention. Typhoid fever is not the only water-borne, 
parasitic disease that may be derived from a well. In the interest of the conservation 
of health, the biologic origin of contagious disease should be adhered to ; not letting go 
of experimentally established truth on the one hand, and not failing to seize upon every 
proper occasion to improve on the sanitary lessons which are warranted by such truth. 

Along the route of the inner lining of the alimentary canal are distributed from 
twenty to thirty generally circular patches, or aggregations of glands. These are called 



OHIO STATE BOARD OF HEALTH. 317 

" Peyer's patches," in honor of their discoverer, Johan Peyer, a Swiss professor of elo- 
quence and dissection, in 1653. In these later days one has to pause and hold his breath 
in admiration of the wide-apart functions which were so harmoniously fused together in 
the person of Professor Peyer. His eloquence, like that of myriads of otheis, has died 
away with the sound of his voice, and, but for the encyclopedia, would have long since 
been forgotten ; but his anatomical discovery, linking his name with the development of 
science, has sssured the perpetuation of his memory in the hearts of the benefactors of 
mankind. He was the Stanley who fxplored the darkest recesses of the ileum, while 
Eberth, with the instinct of the true naturalist, pointed out the formidable propensities 
of certain organisms if they were carelessly given admittance. 

In a recent address by Dr. S. P. Wise, a member of the Ohio State Board of Health, 
it is iutimated that the Eberth miciobe has some very v eked partners. He does, how- 
ever, emphasize the fact that, whether it be the chief, or only a partner, that engag s in 
the businesp, the lesson is just the same. All have the same tendency to fix their homes 
in such soluble, decomposing orgi'.nic ma'ter as may ultimately float them over the 
patches of Peyer, and all, alike, giye a wide berth to the homes of the clean. 

These patches are most numerous in the ileum, hence the tenderness of typhoid 
patients in the right side, where these inflamed and ulcerated patches, or glands, are, to 
use a common phrase, tie favorite feeding-ground of the bacillus typhosus. 

All living things have their preferences in the way of alimentation and reproduc- 
tion, and the invisible bacterial family is no exception. The inciting causes of leprosy, 
of pneumonia, of phthisis, of cholera and of diphtheria have, each one of them, their 
organs, or set of organs, which constitutes their strong citadel, and in which, when once 
intrenched, they elaborate those formidable poisons which heavily tax, and perhaps 
destroy, the vital powers of their most unfortunate victims. 

I quote from Sternberg's recently published " Manual of Bacteriology " as follows: 
" Eberth demonstrates the presence of the typhoid bacillus in the spleen and diseased 
glands of the intestines in 1880. The disease is due to a micro-organism which is cap- 
able of multiplication outside of the human body in a variety of media, at comparatively 
low temperatures, and is widely distributed, and is a hardy microbe. Eberth's bacillus 
complies with all these conditions. 

" The pathogenic power of this bacillus depends on the formation of a ptomaine 
rather than upon a special faculty for multiplying in the tissues of the living animal. 
This bacillus retains its vitality for many months. Sternberg preserved bouillon cultures 
for more than a year in hermetically sealed tubes, and found that development occurred 
promptly in nutrient gelatine inoculated from these." 

Sjeaking of disease transmission, Sternberg says : " Among the pathogenic bacteria 
which are liable to find their way into drinking water, the most important, from a sani- 
tary point of view, are the bacillus of typhoid fever and the spirillum of Asiatic cholera. 
Both of these micro-organisms are present in great numbers in the excreta of persons 
suffering from the specific forms of disease to which they give rise, and are consequently 
liable to contaminate wells and streams which receive surface water. Epidemics of 
diseases have been frequently traced to the use of such contaminated water. Laboratory 
experiments indicate, however, that continued increase of these pathogenic bacteria in 
drinking water is not likely to occur, except under special conditions, and that they die 
out after a time, being at a disadvantage in the struggle for existence constantly going 
on among the numerous species which have their normal habitat in water." 

The inciting cause of typhoid fever is, therefore, a micro-organism. Microbes are 
very small, varying from a 500th to a 50,000th of an inch in length. The bacillus of 
Eberth is about half way between. They can hardly be classified as vegetable or ani- 
mal — they are microbes. Water carries tbem long distances, and they may live a long 
time. Pradden found them alive .if -ir being imbedded in ice thirty-seven days. Warmth 
and the presence of organic matter prtmote their growth. A bacterium will divide into 
two in an hour ; tht^se two become four in another hour — a rate that gives 17,000,000 as 



3l8 ANNUAL REPORT 

the increase of one day. In less than five days they would, at the same rate, fill all the 
great waters of the earth. 

But they have their enemies. Pasteur found that oxygen attenuates and extin- 
guishes them. As we ascend the mountain, or push out into the sea, the air-borne 
microbes become fewer and fewer. In mid ocean and on the mountain top the air is freed 
of their presence. Also the waters of deep springs and artesian wells are generally found 
to be meagerly peopled by water-borne micro-organisms. 

On the other hand, river and other surface waters swarm with them. Stagnant and 
defiled waters constitute their ideal habitat. Filtration through sand beds and porous 
porcelain is ascertained to have reduced the proportion of them, sometimes from forty- 
three to one. Of course, boiling and distillation kill them. 

Three-fourths of the weight of the human body is water, a mineral which becomes 
fluid at a lower temperature than most minerals, and stays melted, like quicksilver, at 
ordinary living heat. Ii not only constitutes part of the body, but it is the mechanical 
agent for the admission of nutrition into the body ; it distributes the same to its various 
destinations ; it gathers up and carries away the debris. And yet water receives as 
little, and often less, attention than anything about the house. There are those who, in 
these later days, filter or boil where there is the slightest suspicion ; but they are, com- 
paratively, the rare exception. Outside the city supply, and often inside its reach, the 
well is depended on for drinking water, and contaminated wells cdfnstitute a prolific 
source of disease. The general subject of wells can be reviewed, more intelligently after 
presenting a few examples, or modes of water infection. 

More than fifiy years ago, in 1843, the little village of New Boston, Erie county 
New York, furnished the most striking illustration of the dangers that may lurk in such 
a well as that just adverted to that has yet been reported. A young merchant had 
bought goods in New York City and was returning home westward by stage coach when 
sicknets compelled him to stop at the village tavern, where he died of typhoid fever. 
Two weeks laier there were sick persons in every family of the village except three. Of 
the forty-three inhabitants composing the village twenty-eight were sick and ten died. 
All the families got their drinking water at the tavern pump except the three families 
above referred to. The three families that escaped were those of a father, his son and 
son-in-law. The father had had a quarrel with the landlord, and thereafter he and his 
avoided both the landlord and his pump. The landlord brought suit against his enemy 
for poisoning the well. Dr. Austin Flint, of New York City, was sent for. 

Dr. Flint was one of the early pioneers in that field of investigation which occupies 
your attention here to-day. He was a representative of those advanced thinkers who 
believed that contagions were due to a cause common to all; in fact, were due to air, 
water or food that had been infected by specific, living, reproductive micro-organisms of 
greater or less virulence. Both he and Gerhard and Pennocke, of Philadelphia, and 
others that might be named, on both sides of the Atlantic, had publicly sustained the 
germ theory — only a theory then — by arguments that left a profound impression. They 
must not be forgotten. If the methods employed by modern State and local health 
boards have anything in them worthy of commendation ; if the destroying angel has 
turned a more kindly face toward the children ; if men sicken less and live longer; if 
cholera has been barred out of enlightened society; if the pestilence that stalketh at 
noonday has been pushed back into his lair and shorn of his mysteries and his terrors 
by the sharp scimeter of experimental truth, then let us not forget the early watchmen 
who, from out of the night of fear and ignorance and superstition, hailed the first dawn 
of a new era and electrified their fellows by pointing the finger of well-grounded prophecy 
to the aurora that streaketh the approaching day. 

Dr. Flint's investigation established the following sequences : The dejecta of the 
fever patient had been thrown into the privy pit. The latter was a pocket in the sand, 
its bottom only a few feet above a clay-seam ; its leachings reached the clay-bed and ran 
along seventy-five feet to the well. The inner surface of the well, ^t the depth of the 



OHIO STATE BOARD OF HEALTH. 319 

<;lay, and from that point down to the water, was coated over by a greenish-brown streak 
of filth. The well was closed and the fever stopped. The man who had been accused 
of poisoning the well had a good case for damages for slander, and did commence pro- 
ceedings, but in view of his complete vindication by Dr. Flint, and of the calamities 
that already overwhelmed the community, he voluntarily relented. 

Scarcely second to the above in dramatic incident was the experience of Lausen, a 
Swiss village that was suffering sorely from an epidemic of typhoid. The water supply 
was a spring bursting from the base of a mountain, noted far and wide for its beauty 
and purity. Certain observing persons had noticed that the volume of its water swelled 
and shrank according as there was high or low water in a stream running through a 
valley on the other side of the mountain, several miles away. In a hamlet on the bank 
of this stream there had been a fever epidemic. The scoffers scoffed, but the aforesaid 
observers threw flour into the stream. The spring was not affected. The insoluble 
suspended particles were detained by the earth-filter. They then threw salt into the 
stream, and the spring promptly became salt water, clearly showing by what route the 
fever which prevailed in the village had reached the city. 

Parenthetically, it is worth while here to remark that while salt ceases to be appre- 
ciable to the taste when diluted in water beyond the ratio of 426 parts to one, there is 
now in use in Germany a new disinfectant, and detective as well, named saprol, which, 
being thrown into the privy vault, reveals whether wells are affected by soakage with 
much certainty. Both the smell and taste of this chemical are perceptibly present when 
it has been diluted in the proportion of 2,000,000 parts to one of water. It is the ever- 
lasting, untiring German who keeps "pegging away, and pegging away," and thus, now 
and then, bringing to light new safeguards to health and life. 

A visitor carried the fever to Iron Mountain, Michigan. From him it reached a 
well, and from this well it went, through a sandy seam, to all the wells in the town, 
carrying sickness and death on its way. 

In digging a deep sewer trench in Canton a strong water-seam was encountered, and 
the wells supplying a row of houses on a street lower down promptly went dry. If, on 
refilling the trench and restoring the water, the fever had subsequently broken out 
among the residents of that street, the old way would have been to attribute the calamity 
to inscrutable Providence, instead of to a leaky sewer. It would have been, in fact, not 
the act of God, but the lack of God's pure water. 

A young man who had spent the holidays in Philadelphia returned to his home, 
located on the banks of a stream several miles above Plymouth, Penn., in January. 
Among the things he took home with him from the city were the seeds of typhoid fever. 
His dejecta was thrown out upon the snow. It was a rough, sparsely settled region, and 
a thaw in March washed the hillsides off into the stream. A month later there had 
been eleven hundred cases of fever and one hundred and ten deaths in Plymouth. The 
wells in the town were dug in the sand, their water-levels rising and falling with the 
volume of the river. The users of well water were stricken the same as the rest. 

Dr. Ashmun, formerly health officer of Cleveland, visited a house in which fever 
was present. Finding the cesspool full he ordered it to be emptied. As the level of 
the contents of the pool went down, he noticed that the water in the house well subsided 
also. Further inquiry established the fact that this criminal intercourse between well 
and cesspool had been going on for a long time and had borne large fruitage of disorder 
and death. 

Only several months agi a spring broke out of the mountain side close by a hospital 
near San Francisco. The water was clear and there was great joy among the officials, 
who ordered the new spring to be safely guarded. Dr. J. K. Laine, secretary of the 
California State Board of Health, aware of the little likelihood of such a spring, and 
also knowing the route of the hospital sewer, suggested the possibility of a leak in the 
latter as the source of the spring. There was a leak. It was repaired and the spring 
went dry. 



320 ANNUAL REPORT 

In one of Dr. Probst's missionary tours he found a village located on abed of porous 
limestone, only a few feet from the surface. Excavations in this rock constituted both 
wells and privy vaults. Twenty-one years of health were succetded by seven years of 
fever. The doctor prescribed the dry-earth system, instead of vaults below, and for the 
surface above the removal of all garbage and manure. The good goFp"l of cleanliness 
bore fruit in complete salvation. 

It may be here remarked that the water from wells in New York City has been 
found to be polluted at the depth of 1,000 feet, because the dip of the rock is nearly ver- 
tical ; while that from only a few hundred feet below Paris and London is pure, because 
the rock-seams are horizontal and the water comes from a distance. ^ 

As a result of the information gained and published there has been, on the part of 
thinking people, a decided interest taken in the subject of drinking water. I say think- 
ing people;- and these are as one to one hundred of those who act from impulse only. 
Therefore this phase of educational campaijjning has barely commenced. 

Even these few thinkers have commenced their thinking none too soon. While the 
country remained sparsely settled and agriculture absorbed the attention of the great 
body of the population, dang-rs to drinking water were comparatively rare. In emerg- 
ing from country to village, and from village into city, personal environments are 
changed. Farmers may do, and keep on doing, things which urban residents may not 
do. The city affords superior advantages and attractions. It is also the target for many 
venomous f jes from which the ruralist goes scot free. Many suppose that they can go on 
living in the city as they did in the country, and their children after them, taking no 
other precautions to insure their healih than before. This would be a great mibtake — a 
fatal mistake. If persisted in either they or their successors will pay the forfeit with 
their lives. It is a fact to be well remembered that with people came trouble, and in 
swift ratio. The hardest enemy we have to fight is ourselves 

When the attention of reading men had been once fixed on the subject by published 
investigations there was a sudden and simultaneous outburst of literature on the subject 
of water contamination. Physicians, and occasionally other people, had hundreds and 
thousands of cases to report ; epidemics, the inciting causes of which had been beclouded 
in mystery, but now new truths and a new dispensation had partially lifted the clouds 
and gave promise of a brighter day. I have presented a very few of the published cases, 
selecting the same with the special purpose ot exhibiting some of the incidents wliich 
may lead to the infection of a well by Eberth's bacillus, and showing that the poison 
may, as the result of carelessness, enter the well in each one of the following methods, 
namely : It may enter the well at the top, or it may go from a cesspool and enter at 
the side or bottom; it may go from one to the other through many feet of limestone 
rock ; it may descend 1,000 feet through a seam in the rock ; or it may reach the inter- 
ior by leeching down from the surface ; or it may travel from one well to another on the 
same water-bearing seam ; or it may break through a leak in a sewer and emerge as a 
surface spring: or it may sail down a river two miles and then pass into wells located 
near the water stream ; or it may travel an equal distance under a mountain and emerge 
on the other side fully fanged for the work of human destruction. 

As I have already stated, the examples prfsenfel above were chosen with the design 
of illustrating certain modes of transmission. Because typical cases were taken it must 
not be inferred that new ones are not occurring. The contrary is true. Here are some 
that have fallen under my eye very recently: 

"Indianapolis, Ind., I^ovember 7. Reports to the State Board of Health from 
diff"erent sections of the State indicate an unusual amount of typhoid fever as a result of 
the low temperature and bad water during the summer. In many counties the mortal- 
ity reaches from SSg to 40 per cent, of the cases reported." And so on, showing up a sad 
Btate of affliction. 

" London, December 12. The origin of the typhoid fever epidemic that r;iged here 
for Heveral months has been discovered. A delegation of health officials got wind of 



OHIO STATE BOARD OF HEALTH. 321 

something wrong on a watercress farm. They paid a visit to the farm and made the 
extraordinary discovery that the water that flowed through the ditches for the propaga- 
tion of the cress was strongly permeated with sewage, and that consequently the germs 
were absorbed by the plant and thus likely to be communicated to the individual par- 
taking of the cress." 

MiDDLETOWN, CoNN., December 4. An epidemic of typhoid broke out among the 
students of Wesleyan University, and its cause has been carefully traced by Dr. C. A. 
Lindsley secretary of the State Board of Health, working in conjuntion with others, to 
oysters eaten by students. These oysters were placed for a time in a fresh water creek 
at New Haven for refreshening and fattening, within 300 feet of the outlet of a private 
sewer from a house where there were two cases of typhoid." 

These three are only a tithe of the aggregates, but consider what they represent! 
More than a hundred deaths; more than a thousand sick beds! Think of the loss to 
society ; of the inexpressible sorrow to the homes! And all this might not have been — 
would not have been, had intelligent precautions held the places of carelessness and 
ignorance. With what new and startling significance does the mind revive the opening 
paragraph in one of the reading lessons of boyhood: " We must educate; we must edu- 
cate ! " 

There is a town in Ohio noted for the intelligence of its people. Its well water for- 
merly came from wells about thirty feet deep, with a shelving rock bottom. There was 
no live water — all was leechings. In time typhoid declared its presence. W^ater works 
were built, the supply being taken from a large hole dug to a low pocket of the shelving 
rock. This drained the wells above, and underdrained the town. The fever went right 
on. Some of the proprietors whose wells had been drained by the water works well, 
excavated pockets in the rock in their well bottoms, thus catching and retaining as much 
of the drained water as possible for their domestic use. They suffered from typhoid the 
same as before. Dr. Probst advised the town to get a better water supply years ago. It 
was not done ; neither has the fever relaxed its attentions — especially has the year just 
passed been fraught with heavy calamity. 

The most stunning recent indictment of typhoid-breeding wells is a document 
entitled: " Typhoid Fever in the District of Columbia, by the Medical Society of the 
District." From this report, which is startlingly precise in its statements, it appears 
that the fever rate of Washington is one of the highest. The Capital City of our 
boasted republic ! '' 'Tis strange, but 'tis true, and pity 'tis 'tis true." Red spots on a 
good city map show the lots on which there have been deaths from typhoid between 1888 
and 1892; blue spots indicate the locality of public wells; and other spots show the 
place of each privy. The ratio of frequency is almost exactly the same in all. 

While it would seem to be almost impossible to exterminate the zymotic diseases 
with a known cause as completely as theory would indicate might be possible, and 
while this is especially true of typhoid fever, the success of intelligent effort in extermi- 
nating these calamities, constitutes one of the most hopeful and glorious pages in modern 
history. Thorough purification is the key to that success. There is no half-way house* 
The soil is the foundation. Clean the soil and then you will have pure water, and air fit 
to breathe. Take the cases of Memphis and Vienna. 

Memphis washed and scrubbed in '78, the first of her two cholera years. She was 
the cleanest city in America. It was a surface polish. The plague redoubled its on- 
slaught in '79, nor would it stay its hand until the streets had been ripped up and the 
wells and cesspools abolished together. 

Vienna, with excellent sewets, had a death rate from dysentery of seventy per 1,000. 
With the introduction of spring water the rate fell to, and remained at, about one per 
cent. Brooklyn, with good sewers, and water double-filtered through the sands of Long 
Island, has the lowest typhoid death rate in America ; and Washington, with many bad 
sewers, and many wells, has one of the highest. 

21 ST. B. H. 



322 ANNUAL REPORT 

There are wells and wellf ; wells which supply- water drained from the contagious 
surface area, and wells furnishing water from a distance. The latter may be classed as 
springs; springs whose source is relatively high, as in the case of artesian wells; springs 
which are popularly known as such, and whose supply source is about as high as the 
point at which the water emerges from the earth. As the source is generally lower than 
the surface, so a well has, in most cases, to be dug in order to reach the water level. 

Every well dug is a drain for the reception of water from the surrounding earth. 
The impurities will go along, unless filtration takes place. The filtering may be effective 
for a time, but the fouling process reaches farther and farther down, year after year, 
until the water is reached. At considerable depths below the surface the oxidation, 
which near the surface keeps the filter effective in intermittent filtration, goes on slowly, 
or not at all. The action of the earth is mainly that of a sieve which removes only 
suspended impurities. Whatever is in solution remains in the water. Mineral waters, 
heavily laden with soluble salts, as well as waters thoroughly impregnated with cess- 
pool or barn yard products, may be as clear as a crystal, sparkle temptingly, and taste 
well. Clearness is no proof of purity. 

For every foot of the well's depth it will drain from three to six feet in width, owing 
to the nature of the soil. A well twenty-five feet deep will drain the surface from 50 to 
200 feet in all directions. If it reaches or penetrate* a shelving rock or clay stratum it 
may receive leeching waters from a cess pool or barn yard 1,000 feet away. 

A dug well is rendered more suscepitble to injury than a driven well by the double 
fact that it is a more capacious drain and a poorer fiUerer. Copious wetting, or rains, 
carry impurities farther down, also bring the water level up, thus facilitating an evil 
contact. When once infected the period of drouth and consequent low water is most 
dangerous, owing to the great concentration of the contents. The low water period has 
been the most fruitful of epidemics. 

The presumption should be that water coming from the sky above and from the 
depths of the earth is good. Rains over cities bring down plenty of non-pathogenic 
germs, but are not generally liable to objections which cannot be corrected by a good filter. 
If well water is from a live source, that is, if it comes from a distance, and if its im- 
purities are only dissolved minerals, not sufficient in quantity to affect its palatability, 
then it is presumably good. The general supply from wells is of this character. 

There are on record some notable cases of the restoration of infected spring and well 
water to purity. In a wide valley in England the rural inhabitants had been supplied 
by underground water, partly from artesian wells, partly from springs and partly from 
dug wells. On each lot, as in this country, there was a privy to carry things down, and 
a well to bring the water up. After centuries of earth defilement this water stratum 
became polluted. Diarrhoeal diseases made it evident that no part of the valley was ex- 
empt. The protection of the soils and streams of the drainage district by police authority 
has resulted in lowering the sick and death rate to a degree which indicates a wholesome 
water supply as the benign result of burdens and restrictions which aroused great oppo- 
sition in England, and the application of which would be impossible under the constantly 
changing regime of our political system. 

Statistical reports showing the benignant fruits of the purification of water are 
more abundant than they used to be, and yet comparative views indicate that only a 
beginning has been made. We all think of war as a thing full of horrors. In twenty- 
two consecutive years of war England lost 79,700 lives. An epidemic of filth disease 
carried off 144,000 lives in one year. In the five years of our civil war 500,000 lives 
were lost. In an average of five years more than 800,000 persons died of preventable 
diseases. 

Tables are often seen showing death rates before and after the taking of certain san- 
itary precautions. These tables show the saving of a great many lives that would other- 
wise be lost. In nine cases out of ten the resultant lessons from these tables are predicated 
either upon a change of water supply or on some other phase of eflort having an 
ultimate relation to the subject now under review. 



OHIO STATE BOARD OF HEALTH. 323 

Long before the discovery of aoy of the baleful micro-organisms, Dr. Benjamin 
Rush said : "The means of preventing pestilential fevers is as much under the power 
of human reason as the means of preventing the evils of lightning or common fire." 
Dr. Rush is reported to have also said that when a case of typhoid developed an indict- 
ment of somebody should follow. Railroads and other corporations are required to ex- 
ercise due diligence in protecting against personal injury, and society may sometime 
demand that corporations exercising a wider scope of power shall be held responsible for 
permittiug the existence of any cases of filth disease. 

Healthy living not only lowers the death rate; but also promotes immunity from 
disease. This was clearly proven by Dr. Wise in his article above referred to. The in- 
fection first weakens, then kills. Whatever cause saps vital resistance, pushes the door 
open 80 much wider. The women and children of Plymouth were just emerging from 
the confinement of a long and rigorous winter, with its consequent vital depression 
when the enemy stole among them and laid waste their homes. 

In taking this cursory review of the relations of wells and typhoid fever I could 
not know what special lesson those who assigned me the subject desired to have taught. 
They certainly expected the suggestion of no specific remedy. That is clearly impossible. 
There are as many w^ls as houses. The difierences in situation are infinite. Many 
phases can hardly be touched upon, such as rainfall, evaporation and absorption, geologic 
formations; tests of waters; mechanical filtration; relations to the subject of diarrhoea 
dysenteries and lowered vitality which precede typhoid, and the general subject of re- 
sistance, and receptivity; cost of doing, or not doing; co-operation in cleanliness; is the 
infection air-born as well as water-born? are animals susceptible to it? relations to 
water supplies and sewers in cities. 

Efibrts to suppress an epidemic are occasionally favored by an accident. Between 
July 7 and September 7, 1873, there were 107 cases of typhoid at Armley, England , 
The health officer found that all the cases occurred on the route of one milk dealer. 
Milk is only rarely accountable for the disease. The health officer chained and locked 
the milkman's pump handle. The handle stopped, and so did the fever. 

First of all it might incidentally be said, and should always be said, isolate and dis 
infect;' These things will not be neglected by any physician worthy of the name. Give 
to charlatans and mushroom sanitarians a wide berth. If you have given due attention 
to the subject of healthy living, if you have been spreading the gospel of pure air, pure 
water and pure soil, you will know that the prime factor in locating your well is its sur- 
roundings. An ounce of prevention is worth a pound of cure. Let no puffed up conceit 
about looks and taste, or forked-stick oracle, lead you to ignore the environments of your 
well. Even a chemical analysis should not blind your eyes to surroundings. It is of 
little consequence to know exactly how many grains of earthy alkaline salts are in the 
water; but don't drink water that comes from under the city, or the barnyard, or the 
cesspool, or factory. Eliminate surface wash and impurities by filtering, and sterilize 
if possible danger by boiling. 

If the typhoid poison is in the vicinity, boil and filter — distill if possible. In case 
of doubt get the opinion of a chemist. There is no chemical, or patent nostrum, which 
by addition to a polluted water, will make it pure and wholesome; but a correct analy- 
sis will dissipate mystery. Aeration, sedimentation and filtration will not render fever- ■ 
tainted water safe. Boil it also until a pure supply is made available. 

The safest general prophylactic is a sound common sense, grounded on a knowledge 
of what typhoid fever is, and its possible methods of transmission. It is an ubiquitous 
foe. It has every country, and season, and clime, for its own. The campaign against 
filth and disease, and in behalf of pure drinking water, should^have universal co-opera- 
tion. Forewarned by the lessons of the past, and^forearmed by a stout determination, 
and sustained by an enlightened and discriminating public, the enemy can be kept at 
bay, and victory will crown the efforts of those who deserve it. 

It i^ true that greit men, followiagj the lead) of Jenner and Pasteur, are makin 
grind discoveries which tend to place therapsutics among the exact sciences, but theff 

T 



324 ANNUAL REPORT 

are only the advance guard in this most noble crusade. If the invading enemy is to be 
overthrown, it must be done by the local board of health. To the real student of this 
phenomena nothing can be of more pointed interest than the reports of our health 
boards. One officer named eight cases of scarlet fever as having occurred in his town, 
but said " they were too mild to report to the local board." This was in 1892. In 1893 
there were 27 cases of the same fever in the same town. Scarlatina may be mild, but 
never too mild to report. Another report concludes with this admirable statement : " All 
contagious diseases have been cared for, and we know of no instance where infection has 
been carried outside of the houses in which the disease originated. " And still another 
secretary of a local board, reporting on six cases of typhoid fever in six houses, says the 
precautions taken were : '' 1, boil all water ; 2, give patients their own dishes and scald 
after using ; 3, no person to eat anything in the sick room, or that had been there ; 4 
disinfection of soiled clothing and excreta. " Useless to say that there were no second- 
arv cases either in or outside of the six houses. Again I say that if this is to be a mil- 
lenium of good health it must come through you, the representatives of the local boards 
of health. To you it is given to enforce the old English common law of cleanliness, viz., 
the law that no man has a right to injure his neighbor. The great discoverers may 
plant, and State boards may water, but you must give the increase. It is you who have 
been placed on guard over the homes and lives of the people. When the insidious foe 
creeps in, and danger threatens, fail not, and fail never, to fling out the red flag of im- 
pending calamity, and thus assure safety to society, and to yourselves the grateful 
remembrance of your fellowmen. [Applause.] 

Dr. Garrigues, of Massillon : Mr. President, I have listened with a 
great deal of interest, indeed, to the article read by Mr. Hartzell. I think 
a great many points of much interest are contained in the article, and the 
gentleman most certainly has my thanks for the very able article he has 
written, and I expect he has the thanks of every person present who is 
interested in these matters. 

Dr. Young, of Chicago Junction : I would like to relate something 
concerning five cases of typhoid fever in our town. The house wherein 
the first case occurred was directly back of my house. Our water supply 
is from cisterns. The first case was an old German lady, who complained 
of diarrhoea, but she recovered after being sick some time, and in two 
weeks from that date a son-in-law was taken sick and died from hemorr- 
hage of the bowels. The slops, etc., were carried around to the side of the 
house and thrown onto the ground — the discharges from the bowels and 
everything else. His brothers went there to take care of him. Two broth- 
ers died, and there were five cases altogether in the family and four 
deaths. There was a defective cistern there, and there can be no doubt 
but that was the way the sickness was caused — from drinking im- 
pure water. 

Mr. Carey, of Wilmington : Gentlemen, I am not an M. D., simply 
president of the local board of health of my town, and I would like to ask 
what would be the proper course to pursue in a case of this kind : Sup- 
pose a health officer wanted to inspect a we^l. Where would be the proper 



OHIO STATE BOARD OF HEALTH. 325 

place to have the examination made, and what authority should pay 
for it ? 

Dr. Probst : There is no provision in the statutes for such cases, and 
unless local boards are prepared to pay for such examinations, I don't 
know what to suggest. I mean to say, there is no fund set apart for that 
purpose that we could use. In the state of Michigan they have a labora- 
tory connected with their college at Ann Arbor, under the direction of the 
State Board of Health. Anyone can send in samples of water, or any- 
thing of that kind, and a proper examination is made by the authorities. 
It would be an excellent thing, indeed, if the people of Ohio could see the 
advantages of having such facilities here. We have arrangements with a 
chemist who does work at very moderate rates, and occasionally have 
examinations made by him. It is not always possible to tell whether a 
well is polluted with typhoid fever germs. There is some doubt as to 
discovering the germs by bacteriological examination. 

Mr. Walton, of New Burlington : I simply want to say that I have 
been very much interested in Mr. Hartzell's paper, and am somewhat sur- 
prised at the power of the bacilli to penetrate the earth. We have been 
troubled on account of shallow wells in some parts of our township. In 
some localities where those shallow wells are we have dug through from 
four to six feet of loam and clay, striking a bed of gravel, which varies 
from twelve to thirty feet. At the bottom of the gravel a reasonable sup- 
ply of water is found — sufficient all the time except during extremely dry 
seasons. In some localities during the dry season typhoid fever has ap- 
peared. We thought there might be a remedy for this by penetrating the 
earth deeper, and a couple of persons drilled two wells in one of these 
localities, going through the clay some thirty feet, and drilled the other 
one into a fine sand, from which came an abundant supply of water, so 
that all surface water was shut off, and we find that it has been of great 
benefit to the neighborhood ; at least, there has not been much typhoid 
fever since that was done. We supposed, naturally, that it would shut 
off all this source of disease, and we hope it may. We had a family in 
the village using water from a surface well, a well supposed to be pure, 
good water, coming from pure, clean gravel, and yet the whole family 
became sick, six or seven of them taking typhoid fever. That family has 
been using water out of one of those deep wells since, and they have had 
no trouble or sickness. I feel that where this can be done it is a good 
thing. 

Dr. Hoover : Before referring to the paper, I want to say a word or 
two that I think is proper at this particular time. I hope that no town- 
ship ofl&cer who is interested enough in sanitary afiairs to come here feels 
that we expect him to say nothing simply because he is not a doctor 



326 ANNUAL REPORT 



/ 



One of the most gratifying evidences that the doctors have been able to 
educate people up to the necessities of these things, is that a great many 
of the best sanitary officers that we have in this State are not professional 
men, but laymen — :men who are, in their walks in life, of the same class 
as the man who has just read this paper, which was so excellent in every 
way. He is a man who has given a great many years to the study of 
sanitary matters, and you can see from the character of his paper that he 
has studied for a very wise purpose. It was an excellent paper and covers 
a great deal of ground. I only want to say that I am in hearty accord 
with the views promulgated by Mr. Hartzell in his paper ; that we cannot 
help but believe that one of the most prolific sources, among numerous 
others in this country, of typhoid fever, is through the water supply. 
There is no doubt about it. It is an appalling thing when we think of it. 
We cannot get along without water. We are so constructed that water is 
an essential to the physiological functions of the body, and yet we are 
going right ahead with our eyes wide open and persistently and contin- 
uously polluting our very source of life. There is not a stream in the 
State of Ohio that is big enough for the outlet of a sewer that is not used 
for that purpose, I am firmly of the opinion, gentlemen, that munici- 
palities, wherever it is possible, should have a public water supply, and 
that supply should be selected with special reference to its fitness. I be- 
lieve that wells, in small towns and villages even, are a menace to health, 
and cannot be otherwise. Especially is it the case when we take into 
consideration the abominable methods that have been in vogue ever since 
communities began to form, for the disposal of night soil. I know in 
country towns the world over the common practice is to dig a square hole 
in the ground for a privy vault and set a small frame structure over it, 
and when the vault is filled within a short distance of the surface, the 
house is removed to another vault and the old one is filled up to the com- 
mon level. They may escape for an indefinite length of time, but finally 
they will pay the penalty for their carelessness. 

Dr. Probst has reminded me of an incident that I had forgotten, 
Some cases of typhoid fever occurred in a certain house. The sanitary 
inspector was sent to investigate the premises, and found that this family 
were using water from a well on the lot, the privy vault only being thirty 
some odd feet away. It was a very deep well, some thirty-five or forty 
feet in depth, and you know that a well will drain for quite a large area 
around it. He very carefully made measurements, reported the well and 
condemned it. He did not ascertain that there was another vault on the 
adjoining lot within ten feet of the well. 

About ten years ago I traced nine cases of typhoid fever to a well on 
♦East Park Place. It had been one of the sources of water supply for the 



OHIO STATE BOARD OF HEALTH. 327 

old Central Ohio Lunatic Asylum on East Broad street. When thai was 
burned down, the grounds were converted into building lots and this old 
well was left open, and was so located that it came on the line of the street, 
within the pavement line, and was left there and used by the public. I 
traced nine cases of typhoid fever one season directly to that well, and 
finally succeeded in having it abandoned and filled up.. 

Dr. W. S. Bookwalter, health officer of Miamisburg, not be present, 
the subject assigned to him, namely, "Do Hogs Fed Upon OSal From 
Slaughter Houses, Afford Wholesome Food For Man?" was not discussed. 

Dr. Hoover, of Columbus : Mr. President, I am going to ask a favor 
of the convention. I do not like to do it, but I am so situated that it is 
impossible for me to be here this afternoon. I am on the program to dis- 
cuss the subject of Expenses of Boards of Health. It will not take me 
over ten minutes to say all I want to say with reference to this matter, if 
I may be permitted to consume that much time at this time. [Cries of 
Go on !J 

Mr. President, I feel very grateful, and haven't very much to say on 
this subject, I was assigned to this subject by the Secretary. He is the 
autocrat of the board of health, and whatever he says we have to do. 
[Laughter.] We know better than to refuse. In order to introduce this 
subject, I want to call your attention to the sections of the law which 
provide for the payment of expenses of boards of health, and I am going 
to do it as briefly as possible. 

In the chapter of the Revised Statutes which directs how the levying 
of taxes shall be performed, the section starts off as follows : 

"Section 2683. In addition to the taxes specified, in the last section, the council in 
each city and village may levy taxes, annually, for any improvement authorized by this 
title, and for the following:: purposes :" 

Sec. 1. Does not concern us. 

Sec. 2. For sanitary and street cleaning purposes, and for street 
improvements and repairs. 

Now it is not necessary to take up your time in explaining how taxes 
are levied. This is one of the items for which the council may levy a 
tax under the direction of the proper persons. 

In cities of the second grade of the first class, such part of the funds 
raised for any of these purposes, as the council deems necessary, shall, 
upon the recommendation of the board of improvements, be appropriated 
monthly for keeping in repair the paved streets of such city. Under the 
laws governing the State Board of Health, or sanitary organizations of 
the State of Ohio, the law that was passed two years ago, and amend- 
ments and revisions of all preceding laws, thereto, reads as follows : 



328 ANNUAL REPORT 

•'Section 2140. When expenses are incurred by the board of health, under the pro- 
visions of this chapter, it shall be the duty of the council, upon application and certificate 
from the board of health, to pass the necessary appropriation ordinances to pay the 
expenses so incurred and certified ; and the council is hereby empowered to levy, subject 
to the restriction contained in the ninth division of this title, and set apart, the necessary 
sum to carry into effect the provisions of this chapter." 

One of the unfortunate things in connection with this ninth chapter 
referred to, is that the sanitary and street cleaning affairs are united under 
one section. Thus when councils do see fit to set aside a certain sum of 
money for sanitary and street cleaning purposes, the street cleaning 
department gets the bulk of the appropriation, because that is for some- 
thing that people can see, and the majority of people don't look out for 
the welfare of the community — its health. It does not say which shall 
receive the greatest amount of this money, and it does not say that the 
council cannot expend money beyond the appropriation. I am more 
inclined, since thinking this matter over, that this is a very fortunate 
thing for the local board of health. If the council neglects to make an 
appropriation of a specific amount for the expenses of the local board of 
health, then you are strictly in it, because you can spend all that is 
necessary and the council has to pay it. Thej'^ will kick, and say they 
won't do it, but they will have to do it just the same. There have been 
several decisions in that matter at different times. They have no option 
in the matter. The law is plain, and it don't make a particle of difference 
what the intention of the author was. It says that when expenses are 
incurred by the board of health, ^^ "'- * it shall be the duty of the 
council, upon application and certificate from the board of health, to pass 
the necessary appropriation ordinances to pay the expenses so incurred 
and certified. There is simply no condition there except the certificate 
of the local board of health. It does not say anything about whether it 
may be deemed necessary in their judgment, whether it is a requisite 
expenditure or whether it should be considered excessive or anything 
about it. It simply says they shall pay it, and they have no option in 
the matter. Councils as a rule do not consider sanitary matters. They 
have matters before them that are more interesting and they have tried 
to obstruct the health department in the cities and towns in every possible 
way, but several decisions have been rendered in favor of the boards of 
health. I will ask the gentlemen from East Liverpool what their 
experience was with the amendment. Of course, gentlemen, I do not 
mean to indicate that I am in favor of extravagance. I do not feel it is 
necessary and I do not think that the health officers as a rule can be 
accused of that thing, when we can get good officers for the munificent 
salary of $100.00 per year, and they are expected to attend to everything 



OHIO STATE BOARD OF HEALTH. 329 

in the way of sanitary matters. When the people were threatened with 
an epidemic like the one in Ashtabula, they didn't hesitate to spend any 
amount of money, while prior to that a little generous expenditure might 
have saved them many thousands of dollars and m any valuable lives. 

People should be educated up to the necessity of preventing trouble, 
of looking far enough ahead to anticipate what might naturally occur by 
the neglect of natural laws. 

I want to say to you before I leave this point, however, that some 
councils have argued that you cannot expend money unless it has been 
previously appropriated. Well, unfortunatel}'- for the man who drew up 
that bill that provides for the duties of councils in levying taxes, he does 
not use the right word. He does not say they "shall." but he says they 
"may." It is not mandatory. It leaves it optional with councils. That 
is unfortunate for councils, but good for us. 

The compensation of health officers throughout the State is wonder- 
fully, exceedingly low. I have always felt, gentlemen, that it was entirely 
too low, but in thinking this over since I have had to talk upon the 
subject, I have concluded that perhaps we had better not say much about 
it. If a man is willing to make sacrifices, such as are demanded of the 
health officer in the discharge of his duties, for the sum of money that the 
board of health agrees to pay, while he may not receive a reward in this 
life, he is laying up treasures in heaven. Most of us. gentlemen, cannot 
have too much credit in that country. It may be that' in the future a 
health officer in a city of good size will be quite a soft snap, paying a 
handsome salary and having large perquisites. One other point that is 
not entirely apropos to this, and yet is indirectly so, is that a member of 
a local board of health cannot be the health officer. This question is 
suggested by the Secretary because he has been so frequently asked about 
it. It is illegal, because he would be required to fix his own salary. 

Just a word about the appropriation for the State Board of Health. 
Ever since this State Board of Health has been organized we have been 
forced to use strictest economy. We have appealed to members of the 
Legislature to increase the appropriation from the original sum of S5,000 
annually to S 10,000 During the cholera excitement, when we had to 
expend an unusual amount of money to guard the borders of our State 
against the invasion of cholera, we got as much as 310,000. Last year, 
although we had asked it and had given good reasons for asking it, 
because of the tremendous increase in the work of the Board, the increas- 
ing demands upon the time of the Secretary to travel in difierent parts 
of the State to investigate outbreaks of disease, the increase necessary in 
our office force to take care of the work there — correspondence, etc., — so 
we could answer your demands when you called upon us, and confidently 



330 ANNUAL REPORT 

supposed we were going to get an increased appropriation, when the 
time came we were cut oflf $2,000. Gentlemen, I want to say emphatically 
that it is an outrage that the State of Ohio has to put up with the paltry 
sum of only $8,000 to preserve the public health, the most important 
office in the State. I say again it is simply an outrage. 

You can help us to get more. None of us gets a salary that compen- 
sates us for the time that is taken up, hut we are eager and willing to give 
that time, provided we will not be handicapped by an appropriation which 
is entirely inadequate to meet the demands of the people. 

Each of you can use some influence with your local representative. 
Those gentlemen, when they come to Columbus, think that whenever a 
man says anything about getting a bill through that he has an ax to grind. 
They don't know, in fact that, bills asked for in this direction a^e of a 
direct local interest to them, and to you, and you can use your influence 
in this direction to secure an increase, and you can enable the Board to be 
that much more effective in the future. Gentlemen, I am very much 
obliged to you for your patience. 

Dr. Sutton, of Zanesville: I have been health officer in Zanesville 
for several years, and I want to say that our town council has never 
refused us anything that we have asked for. We get everything promptly. 
A few years ago, at the time of the cholera scare, we asked for SI, 500 on 
short notice, with which to make special inspection. It was appropriated 
forthwith, and we have never served any notice that has not been com- 
plied with very promptly. We have never asked our county commis- 
sioners for anything that has not been granted. The same may be said 
of all boards in our county. 

And thereupon the convention adjourned until 2 o'clock in the after- 
noon. 



FIFTH SESSION. 



Friday, 2 p. m., January 25, 1895. 

The Chair : Gentlemen, we will now take up the discussion of Dr. 
Hoover's subject on expenses of boards of health. Are there any remarks? 

Mr. Walton, of New Burlington : This question has been ably dis- 
cussed, as far as it has gone, but it has not reached the condition of a 
good many here to-day. I trust and hope that there are a good many 
township trustees here to-day, and consequently members of township 
boards of health, and we have no doubt searched the law to find whether 



OHIO STATE BOARD OF HEALTH. 331 

we were authorized to create a sanitary fund in our respective townships. 
So far we have been unable to find anything warranting us in making a 
special levy for this special work that has been recently laid upon us, and I 
have thought whether or not there should be a law passed by the Legis- 
lature making this matter plainer, so that we could make a special levy 
for this particular work. There is perhaps no work in which we are 
engaged in the township that is of any more importance than the health 
and prosperity of our people. In our township (we are in a rural district) 
we have but about a million and a half, perhaps a little less than that, to 
levy on, and the law says that we shall not exceed certain bounds. We 
are only permitted to levy S4C0 a year to care for our poor, and perhaps a 
sum like this for a general township lund, and so on. And that is the 
largest fund that we can levy according to law. We found some difficulty 
in having sufficient means to carry out all the different branches of the 
work, having to draw largely for extras upon the general fund. We have 
concluded that our Legislature has not laid upon us a duty without the 
expectation that we would be backed up with means, somehow or other, 
to meet the expenses, so we have concluded to levy a sanitary fund, and 
if it is in violation of law, somebody will find it out and stir us up on it. 
It the people refuse it we will appeal to the Legislature. 

I want to ask this question, and I trust this meeting will indulge me 
if I ask it now : We were a little at a loss to know just how, in our rural 
district, we were to find what was really a reasonable compensation for the 
health officer. Last year we employed a health officer and conferred with 
him in reference to what was a reasonable compensation for his services, 
and he thought perhaps S75 for our township would be very reasonable, 
and we could not ste that there was $75 worth of work — only about a 
dozen, or maybe fifteen, reports to make during the year to the State 
Board, and we reduced the compensation to $50. At the close of the year 
we could not find where he had really done $50 worth of work, and are at 
a loss to know what the law would say was a reasonable compensation for 
a health officer in a district like ours. I suppose in large cities he is paid 
6600 or $700 or $1,000 a year. In rural districts, you know, there is but 
little to do. 

Dr. Hopkins, of Ashtabula: Mr. Chairman, I think that sometimes 
we get paid for what we do and more times in the sanitary work we get 
nothing. Our boards of health get nothing but "cussings,'' and our health 
officers get their pay largely in that kind of stuff. As Dr. Hoover has 
said, the compensation of many of us has been but meager. I have done 
in my own city for $50 work that I would not have done in some places 
for $1,000. I told our board at home, I will work for you for $50, although 
it is just a drop in the bucket; it is not pay, but I will work for you for 



332 ANNUAL REPORT 

that price. Finally they raised it to $100. I went through last month 
what I would not go through again for $500. Nobody could hire me to 
do it. Anybody doing this kind of work has to do it for small pay. He 
does it simply because he loves to see something done — because he loves 
to see our children and our homes prosper and enjoy good health. We 
have had no trouble in raising our funds. Our board asked our council 
to pay their bills, and there has been no "kicking" about them. During 
the epidemic we asked for $10,000, and told them that probably we would 
need more than that. And there were no "ifs" and "ands" about it. 
They did not hesitate one second ; we got our money. For the last six 
years I have acted as their health officer, and it certainly has been work 
of education. The people are educated up to the point where they see 
there is some good in it. That has got to be done all over the State. One 
of the grandest things we can make mention of in our State is that we 
have got such boards of health as our brother talks about. I am glad he 
has got good sense and backbone to make the levy for money. 

I have been very much interested in this discussion. We must have 
funds to work with. We have been handicapped a great deal in the work 
by lack of funds. I do hope, gentlemen, that every one of our health 
officers and members who are present here to-day will do their utmost 
with the legislators who come from their districts to work for adequate 
appropriation for our State Board. We have got* hat I consider to be a 
very efficient State Board of Health, and with the money they have had 
at their command they have been doing noble work, and we should back 
them in all ways possible. I want to emphasize what Dr. Hoover said in 
his able speech — every word of it. We want to have good men appointed 
on our boards of health, and if we work things right we will have such 
men appointed. 

Mr. Spear, of Mt. Gilead : I simply want to say a few words in thie 
connection. We certainly have had a very interesting discussion. We 
have had some trouble at times with our town council. We had an epi- 
demic of scarlet fever at one time. Few families were quarantined, and 
all the necessary expenses connected with the quarantining of those 
families were submitted to the council, but they would not allow the bill. 
The bill included expenses for disinfectants, for persons running errands, 
for quarantining, and all that sort of thing. There is another epidemic 
there this year. As I am a member of the board of health I would like 
to have some light on the subject. Five or six families have been quar- 
antined in cases of scarlet fever, and of course bills were sent in for clean- 
ing up, for disinfectants, and everything, in fact, connected with it. Now, 
who should pay them? The board of health or the council? 



OHIO STATE BOARD OF HEALTH. 333 

Dr. Hopkins, of Ashtabula: I think it is an important suggestion 
concerning the members of the board. In our place the mayor has sug- 
gested the names of men for these nominations. I know that our boards 
of health were chosen by the council, but there are ways of getting around 
that, and we can get good men to fill their places if we work for them. 
I will say as to the payments of bills, in cases of poor families being 
quarantined and the husband, of course, not being able to work. As I 
told you we have no trouble about that. Those bills are paid. If it is 
necessary to shut them up, we tell them that you will not starve, will 
have enough to eat and drink, and we will see that proper care of you is 
had, and if they are not able to buy disinfectants, we buy them ourselves. 
We audit those bills and sabmit them to the council for payment. How- 
ever, if the man is able to stand the quarantine, and has got sufficient 
money to carry himself along, we say to him that he must bear the ex- 
penses. We tell him, you are not town poor, and have got funds and we 
will expect you to bear your own expenses. We have had no trouble 
whatever. But a man living on his day labor from day to day we say to 
him, don't you worry, your family will not suffer for anything that is 
needful. You won't get any delicacies, but you will get good wholesome 
food, and all fuel and everything that is necessary. As I say, the council 
never object to these bills. 

The Chair : I suggest if you want to be safe you had better have 
your members elected by the council. In some larger cities they are act- 
ing under special laws, but in the smaller towns and villages, there is a 
method prescribed for the election of boards of health, they being elected 
by the council, and appointment by the mayor has no force whatever, 
and sometimes your boards are not legally constituted. 

Dr. Hopkins, of Ashtabula : Our council chooses our members of 
the board of health. They are elected by the council, but it is customary 
for the mayor to suggest the names for nomination. 

The Chair : Well, I thought you said the mayor appointed them. 

Mr. Walton, of New Burlington : I think the councils should pay 
all bills which are reasonable. There is such a thing, though, as a board 
of health presenting an unreasonable bill, in which case the council is 
justified in not approving the same. I want to say in reference to the 
management of such cases, in our county we are in the habit of paying 
for our county poor who are not able to foot the bills. We certify them 
up to the infirmary directors, and draw part of the money back that we 
expend in caring for them, and consequently it does not come so heavy 
on the township. I suppose the same thing might be done in a village 
corporation. At any rate we take charge of those that are supposed to be 
taken to the infirmary, and instead of taking them to the infirmary we 



334 ANNUAL REPORT 

say to them, that we will foot the bills, and then you give us as much as 
it will cost to keep them there and we will see that they are properly 
taken care of. We get along first rate with the infirmary directors, and 
they commend us for the course we pursue in taking care of the poor. 

A Member : I think that all bills submitted to the couhcil after 
being certifiefl to by the board of health, should be paid. I think if the 
council- can reject a part of a bill, they can all of it. I don't believe they 
have the right to reject an}'- part of the bill, but must pay it all. If six 
men on the board of health deoid© it must be paid, I don't think they 
have any discretion in the matter. 

Mr. Truex, of New Straitsville : The mayor in our town does aiot 
appoint the board of health, but he comes to me and asks me who I want 
on the board. 'Not long ago he asked me to name some men, and I gave 
him a few names and he says, I will appoint them. We have no trouble 
in gettiiig good men. Now when it comes to the bills — we had to quar- 
antine a house and appoint a sanitary policeman. The mayor, told us 
that he did not believe in appointing a sanitary policeman. We called 
the board together and appointed the policeman, but have not yet sent in 
our bill, but we anticipate no trouble in having our bills allowed. 

Mr. Purinton, of East Liverpool : The law recognizes two distinct 
ways in the selection of officers. One is to be appointed by the mayor 
and affirmed by council ; and the other appointed by the council. Now 
then let those who have not looked into this matter, carefully look up 
the subject and see if their various boards are legally constituted, because 
there is a distinction. ' • . 

The Chair : The next subject for discussion is "The Best Method to 
Prevent the Spread of Contagious Diseases in Towns and Cities," the 
discussion to be opened by Dr. P. H. Aldrich, health officer, Defiance. 

Dr. Aldrich : Gentlemen, this subject of mine has been pretty well 
gone over since our meeting has been in session, but there are some little 
matters yet to be considered in the way of the prevention of contagious 
diseases, and the spread of contagious diseases throughout the various 
cities and towns. Now without the assistance of our bacteriologists, and 
finding out what the real cause of these diseases are, we would be of little 
account. In the first place, it is absolutely necessary for us to know what 
we are fighting, what we have to combat, before we commence our work 
of stopping the spread and ravages of diseases. Now, gentlemen, under 
this subject I will take diphtheria* and scarlet fever. They come the 
nearest together of any two that are contagious. In the first place, as the 
health officer receives notice from the physician that he has a case of 
diphtheria in a certain section of the town, he immediately sends his 
sanitary policeman with a card, naming the disease, to nail up in some 



OHIO STATE BOARD OF HEALTH. 335 

conspicuous place on the front of the house, or the door, or where every 
person will be likely to observe it. That card should be of such a nature 
and printed in such style that it attracts the attention of every passer by. 
When a person comes within sight of the dwelling where the cards are 
tacked up, the first thing that catches his eye is the card, if it is rightly 
gotten up. The letters on the card should be at least an inch in size, and 
he will see that he is strictl}' forbidden by the board of health of that city 
to enter that house. Now here I have such a card as we have in our city 
(exhibiting card). It appears that this card is a little different from the 
most of cards. I never saw one just like it. The card, as you have 
observed, is a "diphtheria" card. Now, in addition to the word 
"diphtheria," it reads below : "A/ll persons not occupants of this house 
are notified to avoid entering it utitil this card is removed. By order of 
the Board of Health." Now any person can see that, card for quite a 
distance and they know at once that it warns people to keep away, warns 
them to keep a certain distance from the house. When I get a notice 
that we have a case of diphtheria in our town, I immediately go there 
myself with a sanitary policeman. I tell every occupant of that house 
what they must do and what they must not do. I do not (consider it 
absolutely necessary to quarantine every case of diphtheria or scarlet 
fever, or those diseases that we come in contact with almost every day. 
I have no difficulty in stopping the ravages of diphtheria in our city in a 
short time. I have had two cases I think within the last year and that 
is all, and they were stopped, checked right in the house in which it 
originated or broke out. Nobody left the house and consequently the 
disease was not spread. 

When we have diphtheria it is eight chances out of ten that you find 
that it comes from decayed bodies. Vegetable matter is the most produc- 
tive of the diphtheria. When the sanitary policeman goes on his rounds 
to clean up cellars and lots, and every filthy place in the city that can be 
found, he frequently finds cellars with five or six bushels of potatoes, 
which, perhaps, have decayed, and lots filled up with decayed potatoes, 
turnips, cabbage, etc., and it makes livel}'' work for the garbage-gatherer and 
the sanitary policeman; and if they are good, level-headed men, they will 
work until they get this all nicel}'- cleared up. Then when we come to 
stop this ravage of the disease it has got a little start. As I told you in 
the first place, gentlemen, we will put this card on the hou8| and posi- 
tively forbid any one from enteripg or coming out. Give the inmates of 
the dwelling instructions that if any of them are seen on the street they 
will b9 promptly arrested and locked up until twenty-one days have 
passed for the incubation of that disease. If you do catch them out, do 
.ust as you say. A health officer has got to have a great deal of "sand " 



S3^ ANNUAL REPORT 

and he wants to be pretty sharp, and when you start in for a thing never 
give it up. You may not have a friend in the city to back you in the 
start, but if you do good, they will be your friends in the end. You have 
got to do things regardless of friend or foe. Don't back down for any one, 
not even the mayor of the city. If you do any good in a city as a health 
officer you have got to pursue a course and go straight ahead and do your 
duty in the face of everything. In the first place, ascertain if you are 
right, and then go ahead, not be as I was a year ago when I came into 
this meeting, and I got the worst roasting of any man that ever came to 
this house, Brother Probst can tell you so. I got it for quarantining three 
individuals who had been exposed to small-pox. They threatened to 
lock me up. Fortunately, one of them committed suicide before I got 
back. I went to our city solicitor to look up the law to see what right I 
had to do that. He told me to let it alone — that there was no law where- 
by I could quarantine those men. I found out afterward there was. 

Well, now, perhaps I have said all that is necessary on this subject. 
It is getting late. I want to leave this now for discussion. I want to 
hear what you have all got to say, for I want to learn something. Now, 
gentlemen, with these few remarks I will leave the matter to yourselves, 
hoping that I will hear from almost every health officer in this house. 

Prof. Nelson, of Delaware : I don't know of anything that is of more 
interest to us than this subject. What shall we do when an epidemic 
comes to prevent the spread ? Those of us who were here last night will 
remember that Dr. Miller, of Cleveland, claimed that the epidemic of 
diphtheria at Ashtabula, which lasted less than a month, cost that city, 
I believe, $500,000. I have just been talking to my friend, the health 
officer ot the city, and asked him if he would verify those figures. His 
answer was that it would be impossible to tell exactly what was the loss 
to the city as a result of that epidemic. It came just at Christmas time- 
during the Christmas trade, but he finally said that he had no doubt that 
it cost the city $100,000 at least. There were one hundred cases of sick- 
ness, and if that epidemic cost $100,000, it is perfectly clear, if I remem" 
ber anything about mathenaatics, that each one of those cases of diphtheria 
cost the city $1,000. 

Now, it is very evident to me that there is only one thing to be 
brought clearly before our minds this afternoon, and that is, that it is our 
duty as health officers, leaving out every other consideration, to avoid 
that enormous weight upon us. 

Now, there is no question as to the right of the board of health to 
contract debts. We found that out this afternoon, and there is nothing 
for the council to do but to stand behind us and see that the bills are 
paid. There are certain things we can do and must do in order to pre 



OHIO STATE BOARD OF HEALTH. 337 

vent epidemics of any sort coming to a community. The first thing is 
to placard the house, as the gentleman said this afternoon. Make people 
understand that. Last year it was brought to my attention that an officer 
in one of our towns — a local officer — had announced that if the house 
was placarded he would tear it oif. If he came the second time he would 
have the officer arrested. I would like to have been health officer there 
a little while and see whether that man was going to come out ahead or 
not. I think that placard would have gone up the second time, and if it 
was disturbed, somebody certainly would have been arrested. 

In the second place quarantining must be done. To a man who has 
been earning his bread by daily labor, we say, if you will put this sick 
child in a room and have the mother take care of it and stay away from 
other members of the family, that will answer. But we are simply play- 
ing with that case. It is our duty to see that the house is thoroughly 
quarantined and kept so until everything is over. Some people are not 
willing to admit that diphtheria is contagious, especially in cases of their 
own, so they insist on a public funeral. There should be no public 
funerals in such cases, or in case of any contagious disease ; we should 
not even allow the body to be taken to a church. Say to the friends we 
are sorry, but this is a contagious disease, and a public funeral is forbid- 
den, for the living have some rights as well as the dead, and we must not 
have a public funeral under any circumstances. I mean they must reiuse 
to allow any person to come near the luneral except those absolutely 
necessary for carrying the body to its place of burial. 

I wish we were on higher ground this afternoon than we are, and yet 
friends it does seem to me that we ought to be encouraged. I have been 
looking back this afternoon eight years. Some wanted us to organize 
a sanitary association and we met in this city. We had only about a 
half dozen. We expected that the people of Ohio would rally to the cause 
and thought we would have a house full, but were badly disappointed. 
That was eight years ago. And now, gentlemen, are you aware of the fact 
that there are to- day over 10,000 people in the State of Ohio who are 
officially connected with boards of health? [Applause.] We have be- 
tween 1,700 and 1,800 boards of health, when ten years ago there were 
only a few, and most of them were inefficient, I am glad to see that so 
many have turned out at this meeting and have taken such a prominent 
part in the discussion. I believe, gentlemen, that within a few years we 
can educate the people of the State to such a degree that we will be able 
to stop epidemics of contagious diseases. 

Dr. Hopkins, of Ashtabula : Mr. Chairman, I feel as though there 
is many a one here who would like to say something and ought to say 

22 ST. B. H. 



338 ANNUAL REPORT 

something upon this subject. I am as full of the idea of contagious dis- 
eases as any man can well be. The matter of quarantine I think is one 
of the best things that we can do, to thoroughly quarantine houses con- 
taining contagious diseases. You will find that it is very hard to do that, 
but it must hi done. Placard the house and tell the guard to allow no 
one to go in or out. 

Another thing, after the disease has been disposed of, we should see 
to it that the house is thoroughly disinfected. 

Mr. Spear, of Mt. Gilead : We have had some experience with scarlet 
fever, and the work of the health board was very efiicient indeed. As 
soon as a case was reported it would immediately be quarantined. We 
found it necessary once to arrest and jail one man for violating the rules, 
for failing to report a case. After being in contact with a case he ran 
about the town and spread the disease in that way. 

Dr. Aldrich, of Defiance : Mr. Chairman, now in regard to this quar- 
antining, I might have been misunderstood. I said that I did not think 
it was necessary to quarantine in all cases. I have had some experience 
as a health officer, about two years in a city of 12,000 inhabitants, and I 
have seen a good deal of scarlet fever. It broke out a number of times 
during my term, but I never had to quarantine a single case yet. I never 
quarantined but two houses in two years in our city, and that was for 
diphtheria, and in one of them the servant girl stole out the back door 
after milk, and after she got her milk she found she could get out, and 
afterwards went out. I found out the next morning that she had been 
out, and what could I do then. She had been out, but I could prevent 
her going out the second time. If it is necessary to quarantine a build- 
ing, it is necessary to do it thoroughly. At night time the people will in 
on you and carry it away. You should have guards on duty both day and 
night. In that way you can keep the disease confined to the house and 
under control. I have never found any trouble in keeping it under con- 
trol without quarantine. 

Chairman : Dr. Probst, Secretary of the State Board of Health, will 
now present the subject, "The Abatement of Nuisances." 

THE ABATEMENT OF NUISANCES. 

By C. O. Probst, M. D., Secretary of State Board of Health. 

There is no duty a board of health is oftener called upon to perform than that of 
abating nuisances ; and one of the greatest difficulties encountered by such a board is 
the proper performance of this duty. I venture to say that there is not a city or village 
in this State in which nuisances may not be found, and this, in most cases, is not the 
fault of the board of health, but is due to uneducated public opinion. We should first 
clearly understand what constitutes a nuisance, and we may then consider how nuisances 
may be abated. • 



OHIO STATE BOARD OF HEALTH. 339 

It may be said, generally, that anything which is detrimental to health or comfort, 
or which threatens danger to life or property, is a nuisance. As has been well said, 
" Evfr7 person is absolutely bound so to conduct himself, and so to exerci e what are 
regarded as his natural or personal rights as not to interfere unnecessarily or unreason- 
ably with other persons in the exercise of rights common to all citizens. Every breath 
of this obligation constitutes a nuisance." 

The Legislature of Ohio has declared certain acts and conditions tobe a nuisance. It 
has also authorized the board of health to make orders and regulations for the abate- 
ment and suppression of nuisances. The board has also been given quasi judicial func- 
tions, and may determine the fact whether a nuisance has been committed. When, in 
(he opinion of the board of health, any building, premises, matter or thing is in a condition 
dangerous to 1 fe or health, the board may declare the same a public nuisance and order 
it abated. 

A distinction must always be made between public or common nuisances and those 
that are private, or limited in their effect. Boards of health should deal only with 
public nuisances. 

A public or common nuisance is one which affects or may affect the community at 
large, or a considerable portion of it. A pig-pen, for instance, located sufficiently near 
to a public highway — either a road or alley — so that passers by will be annoyed by the 
noxious oders arising from the pen, is a public or common nuisance. It may be a source 
of constant and a special injury to those living in its immediate neighborhood and be 
for them a private nuisance; but all persons have a common right in the public high- 
ways and are, or may be, to a greater or less extent, injured by the conditions presup- 
posed. On the other hand, supoose that a man plants a thick growth of trees or a hedge 
in such a position that his neighbor's dwelling is shaded, rendering it dark, damp and 
therefore unhealthy. This would be a private nuisance, in no way affecting the gen- 
eral public, and should be abated by the person injured, who may also claim damages 
from the person committing the nuisance. Certain acts or things may be regarded as 
prima facie nuisances; that is, it is only necessary to prove the fact that they were com- 
mitted and not that the act or thing is in fact a nuisance. What the Leg slature 
declares to be a nuisance, is a nuisance, and of this character. So also a board of health, 
acting under powers granted by the Legislature in general terms may declare certain 
things to be nuisances. In such case it is only necessary to show that the order or regu- 
lation is a reasonable exercise of such powers, and that the thing removed or destroyed 
was of the character specified in the rule or regulation. The local law in this instance 
will have all the force of a statute. 

As examples of nuisances which may, prima facie, be regarded as such, may be men- 
tioned : 

(a.) Exposing one's self in a public place when afflicted with a dangerous conta- 
gious disease. 

(6.) Selling or offering for sale diseased or corrupted meats, or unwholesome 
articles of food. 

(c.) Keeping dangerous explosives or combustibles in or near a public place. 
(d.) Exposing or depositing filthy or offensive matters in public places or on private 
premises. 

(e.) Corrupting or rendering impure a well, spring, or other source of water supply. 
Other acts or things may become a nuisance according to circumstances or the 
locality in which they exist or are committed. Take, for example, the business of 
slaughtering. This may or may not be a nuisance, depending upon the locality in which 
it is conducted. If an incorporated village includes within its territory a locality where 
the business of slaughtering may be conducted without creating a public nuisance, as 
already defined, boards of health are not authorized to interfere, as it could not be shown 
that a public nuisance exists. A slaughter house so situated may become a public 
Biuisance bj growth of the community in its direction. This frequently happens. The 



340 ANNUAL REPORT 

owner cannot set up the claim that his siauj^hter house was located there first, or that it 
had existed for any period of time, even a hundred years or more, without creating a 
nuisance. Whenever it interferes with the superior rights of the public it becomes a 
public nuisance and may be abated. 

Certain of these noxious trades which were once considered prima facie, or necessarily 
nuisances, have been removed from this class by means of modern appliances by which 
the offensive odors or gases usually produced may be destroyed. In such cases the 
results of these appliances will determine the fact of a nuisance being committed. No 
matter how much care is taken, the fact that injurious results proceed from the business 
condemns it. 

An important question in abating a nuisance is to fix the responsibility for its crea- 
tion or maintenance. For instance: A owns a dwelling house which he rents to B. B 
fails to clean the privy vault upon the premises, which becomts a nuisance. Who shall 
be held responsible — A or B? 

As a general rule, it is not the owner of the premises, but the occupier, who is 
responsible for nuisances thereon; so in this case B should be dealt with primarily for 
creating a nuisance. He may be fined for failure to abate the nuisance, but this will 
not necessarily remove it, and it may still remain a menace to the public health. But 
A (the owner) is also responsible for maintaining a nuisance on his property, and may 
be required to abate it. If he fails to do so after proper notice, the board may cause it 
to be abated, and the expense incurred becomes a lien on the property. This cannot 
legally be done without due notice to the owner, nor without, except under extraordinary 
circumstances, giving him an opportunity to abate the nuisance himself. The board 
becomes, in fact, a court before which the owner must be cited to appear. He must be 
given opportunity to show cause, if any, why the board should not proceed to abate the 
nuisance. And the law further provides that if he promises to abate the nuisance him- 
self within a reasonable time the board shall grant such time. 

Municipalities may be held responsible for certain nuisances and be required to 
abate them. It may be laid down as a general rule that a municipality is liable for 
nuisances committed or maintained upon property owned and managed for private 
corporate purposes. In this respect municipal corpontions have the same responsibilities 
as private individuals. Thus corporations are responsible for befouling streams, for 
suffering the privy vaults of school houses or other public buildings to be in' a condition 
to menace the health of the people in the neighborhood or of those who resort to them ; 
for the maintenance and proper care of sewers which have been established; for per- 
mitting sewage to be discharged where it will cause a public nuisance, etc. 

In all cases their responsibility is for the mismanagement or wrongful use of 
property belonging to or controlled by the corporation. 

For the abatement of nuisances it is advisable for boards of health to adopt rules 
and regulations, or standing orders, they may be called, prohibiting those nuisances most 
commonly met with. These should include only those nuisances which have been de- 
clared to be such by Legislature or those that are recognizsd as such at common law. 
Special nuisances which may be met with may be dealt by special orders. Care should 
be taken to preserve a complete record of nuisances of a special order, as it may be 
necessary to present this as evidence in court. Special orders are in fact laws, and the 
board must be able to show good reason for their enforcement. 

When complaint is made, or it is discovered that a nuisance exists, the health ofhcer, 
sanitary policeman or a member of the board of health should make an investigation, 
and if a nuisance is found, an order should be served upon the person responsible for 
the nuisance to abate it within a definite and reasonable time. If it is not abated within 
the time indicated, the person may be prosecuted for violating the statute, rule or regu- 
lation governing the case, or the board may abate the nuisance after giving the owner of 
the property an opportunity to be heard and to abate the nuisance himself. 



OHIO STATE BOARD OF HEALTH. 34 1 

When the emergency is great, the bjard of health may summarily abate a nuisance 
without notice to the owner of the property on which it is found or to the person creat- 
ing the nuisance; but if property is destroyed the owner will be entitled to his "day in 
court," and the board will have to show that a nu sance threatening life or health existed 
and that there was good reason for its summary abatement. 

Cases may arise where it is necessary for the board of health to take action with 
reference to nuisances which are only threatened but are not yet created. For instance, 
in one of our villages a company established the business of poultry slaughtering in a 
public place. This was done in cold weather, which prevented the development of bad 
odors to any considerable extent. There was every reason to believe that a public 
nuisance would be created when warm weather should come, but it was held by the 
Attorney General that the board of health must wait until a nuisance had actually been 
created before action could be taken for its abatement. In this case, if the board had 
been able to show conclusively that from the nature and location of the proposed business 
a nuisance must inevitably follow, an injunction would probably have been granted by 
a court of equity. It is only under extraordinary circumstances that courts of equity 
interfere in such matters, and the necessity for so doing must be clearly apparent. There 
is great need that boards of health shcJuld have a legal adviser, as questions of law are 
continually arising which can be settled only by members of the legal profession. 

When possible, a lawyer should be secured as a member of the local board of health. 
It might be of advantage if the prosecuting attorney of each county were made the 
legal adviser of each board of health in the county, a fee being allowed him for his 
services. 

A Member: I want to ask a question in regard to the killing of fish 
in the Sandusky river at Rucyrus. 

Mr. Beardsley, of Findlay : We had a similar case at our place. The 
fish died by the hundreds. The cause was traced down, and it was found 
to come from the brewery. We have an artificial ice plant in the town, 
and the ammonia which is used in that plant in the manufacture of ice got 
into the stream and killed hundreds of fish. I think such nuisances 
should be stopped. 

And thereupon the meeting adjourned sine die. 



INDEX. 



Address — page. 

McKinley, William, Governor 278 

Stanton, Dr. Byron 279 

Aldrich Dr. P. H.— 

on the best method to prevent the 8pread of contagious diseases in towns 

and cities 334 

Alliance — 

report on an investigation of a nuisance at 70 

American Public Health Association — 

report of delegate to meeting of in Montreal , 147 

Arlington Heights — 

report on an alleged nuisance at , 73 

Ashtabula — 

diphtheria epidemic at 298 

report on the proposed sewerage system for. 47 

Athens — 

report on the sewerage of 44 

Attorney-General — 

opinions of „ 151 

Austinburg — 

report on diphtheria in 33 

Bellefontaine — 

report on an alleged nuisance at 73 

Boards of health — 

expenses of 327 

joint meeting of State and local 259 

Bowling Green — 

report on a proposed additional water supply for... 59 

Bradner — 

report on typhoid fever at 38 

Bryan — 

report on sanitary condition of school house at 145 

Catalogue of library 169 

Consumption — 

in Ohio 7 

circulars on 99 

the prevention of 77 

Contagious diseases — 

the best method to prevent the spread of in towns and cities ,... 334 

Deaths and their causes — 

monthly reports of in Ohio 197-249 

summary for the year 250 



344 INDEX. 

Diphtheria — page 

in Ashtabula 298 

Austinburg 83 

Lorain County Infirmary 35 

near Perrysville 36 

Ebright, Dr. L. S.— 

on to what extent, if any, is a board of health authorized to regulate the 

sanitary condition of school bui dings 272 

Eabt Palestine — 

report on the sanitary condition of 141 

Fee, William T.— 

on the disposal of night soil and garbage at Warren 290 

Galiipolis — 

approval of the water supply for. 61 

Gerrish, W. B., C. E.— 

sewage purification at Oberlin 292 

Hamilton — 

report on the proposed sewerage system for 48 

Hartzell, Josiah — 

on well pollution in relation to typhoid fever 315 

Health officers — 

what are the duties of 262 

how may they obtain correct and full names of infants 265 

list of in Ohio 14.5-167 

Health of the State 5 

Hedges, Dr. W. B.— 

on how may the health officer obtain the correct and full names of infants.. 265 

Hoover, Dr. Thos. C. — 

on expenses of boards of health 327 

Howard, Dr. W. T.— 

on the use of anti-toxin at Ashtabula 302 

Kahle, Dr. R. D.— 

on what are the duties of a health officer 262 

Kinsman, Dr. D. N.— 

on the best means for the prevention of tuberculosis in man and animals... 282 

Lancaster — 

investigation of a proposed extension of the water supply of 61 

Library — 

catalogue of 169 

Lima — 

report on an additional water supply for 64 

Lorain County Infirmary — 

report on diphtheria in , 35 

Louisville — 

report on water supply for 66 



OHIO STATE BOARD OF HEALTH. 345 

Mansfield— page 

report on typhoid fever at 41 

Marietta — 

report on a proposed sewerage system for 49 

Marysvilie — 

report on proposed sewerage for 50 

Medina County Infirmary — 

report on typhoid fever at 43 

Miller, Dr. William T.— 

on diphtheria at Ashtabula 298 

Monthly Sanitary Record , 9 

Napoleon — 

report on the selection of a water supply for. 67 

National Woman's Relief Corps Home — 

inspection of 140 

Nelson, Prof. E. T.— 

report on an examination of the problems involved in the selection of a 

water supply for Napoleon 67 

Night soil and garbage — 

the disposal of at Warren 290 

Nuisances — 

at Alliance 70 

Arlington Heights 73 

Bellefontaine 73 

Vinton- 74 

Woodsfield • 76 

the abatement of 338 

Oberlin — 

report on sewage disposal at 51 

the purification of the sewage of 292 

Perrysville — 

report on diphtheria near 36 

Point Pleasant — 

report on typhoid fever at , 40 

Probst, Dr. C. 0.- 

consumption and its prevention 77 

small-pox and vaccination 104 

report on diphtheria at Austinburg 33 

report on diphtheria in the Lorain County Infirmary 35 

report on diphtheria near Perrysville 36 

report on typhoid fever at Bradner 38 

report on typhoid fever at Point Pleasant 40 

report on typhoid fever at Mansfield 41 

report on typhoid fever in the Medina County Infirmary 43 

report on sewerage of Athens 44 

report on sewerage for Marysvilie 50 

report on sewage disposal at Oberlin 41 

report on a proposed water supply for Bowling Green 59 

investigation of a proposed extension of the water supply of Lancaster 61 

23* ST. B. H. 



346 INDEX. 

Probst, Dr. C. O. — Concluded — page 

report on proposed water supply for Wooster 69 

report of an investigation of a nuisance at Alliance 70 

report of an investigation of an alleged nuisance at Bellefontaine 73 

report of an investigation of a nuisance at Vinton 74 

report on a nuisance at Woodsfield 76 

inspection of the National Woman's Relief Corps Home 140 

report on the sanitary condition of East Palestine 141 

report on the sanitary condition of Uhrichsville 143 

report on the sanitary condition of a school house at Bryan 145 

on the abatement of nuisances 338 

School buildings — 

is the dry closet system to be recommended for 286 

to what extent, if any, is a board of health authorized to regulate the sani- 
tary condition of 272 

Secretary's report , 11-31 

Sewage — 

purification of at Oberlin 292 

dispo.^al of at Oberlin 51 

Sewerage — 

at Athens 44 

Ashtabula , 47 

Hamilton 48 

Marietta 49 

Marysville 50 

Warren 57 

Soiall-pox — 

small-pox in Ohio 6 

small-pox and vaccination 104 

conference of representatives of State boards of health 106 

conference of representatives of State boards of health and wholesale cloth- 
iers of Chicago 109 

when it alights in a village, then what? 309 

at West Williamvfield 125 

Harrod 125 

Columbus 125 

Springfield 128 

Shelby 128 

Toledo 129 

Lima 130 

Worthington 130 

Dayton 130 

Vinton , 130 

Lorain 131 

Cleveland 132 

Collinwood 132 

Lucky 132 

Stanton, Dr. Byron — 

address , 279 

report of an alleged nuisance at Arlington Heights 73 

State Board of Health — 

members of 4 

standing committees 29 



OHIO STATE BOARD OF HEALTH. 347 

Typhoid fever — page 

at Bradner , 38 

Point Pleasant 40 

Mansfield , 41 

Medina County Infirmary 43 

well pollution in relation to 315 

what precautions are necessary in the burial or transportation of a body 

when death was caused by !liiifL306 

Tuberculosis — 

the best means of prevention in man and animals 282 

Uhriohsville — 

report on the sanitary condition of 143 

Vaccination , 7,135 

small-pox and , 104 

inspection of the National Vaccine Establishment 139 

Vinton — 

report of an investigation of a nuisance at 74 

Warren — 

report on sewerage for ; 57 

the disposal of night soil and garbage in 290 

Water supplies and sewerage 9 

Water supply — 

at Bowling Green 59 

Galiipolis 61 

Lancaster , 61 

Lima 64 

Louisville 66 

Napoleon 67 

Wooster 69 

Wise, Dr. S. P.— 

on what precautions are necessary in the burial or transportation of a body 

when death was caused by typhoid fever.. 306 

Woods, Dr. Joseph T. — 

on when small-pox alights in a village, then what? 309 

Woodsfield — 

report of a nuisance at , 76 

Wooster — 

report on a proposed water supply for 69 



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Ohio. Dept of health. Annuel report 
V.9 1894